DR. BRENT G NICK (NPI# 1023019205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023019205 |
| Entity Type | Individual |
| Full Name | DR. BRENT G NICK |
| Credential | MD |
| Practice Address |
11714 Wilson Parke Ave Suite 150 Austin TX 78726-4060 |
| Mailing Address |
4515 Seton Center Pkwy Suite 215 Austin TX 78759-5290 |
| Practice Telephone | 7372477200 |
| Practice Fax Number | 5124067368 |
| Mailing Telephone | 5122315506 |
| Mailing Fax Number | 5124066216 |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2017-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Q8978 | TX | Allopathic & Osteopathic Physicians |
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
019461 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 049405603 | 05 | |
| TX | 049405602 | 05 | |
| LA | 1901806 | 05 |
| Street Address |
11714 WILSON PARKE AVE SUITE 150 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78726-4060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093002537 | Serena Hon | Family Medicine | 11714 Wilson Parke Ave, Suite 150, Austin, TX 78726-4060 | 2011-07-06 |
| 1689991879 | Colleen Suzanne Adkins | Allergy & Immunology | 11714 Wilson Parke Ave, Suite, Austin, TX 78726-4060 | 2010-04-27 |
| 1093897555 | Viviana C Frazier | Family Medicine | 11714 Wilson Parke Ave, Austin, TX 78726-4060 | 2006-10-20 |
| 1881669711 | Alison D. Ziari | Pediatrics | 11714 Wilson Parke Ave, #150, Austin, TX 78726-4060 | 2006-02-22 |
| 1346212180 | Maritza Navarro | Allergy & Immunology | 11714 Wilson Parke Ave, Suite 150, Austin, TX 78726-4006 | 2006-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104385152 | Meridian Preferred Network, LLC | Durable Medical Equipment & Medical Supplies | 11512 Tibee Drive, Austin, TX 78726 | 2019-03-19 |
| 1356709083 | Britex | Dentist | 10200 Boulder Lane, #300, Austin, TX 78726 | 2016-02-09 |
| 1205224490 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 7300 N Fm 620, Austin, TX 78726 | 2014-12-23 |
| 1881933372 | Judy Ann Adan | Dentist | 8300 N Fm 620, Bldg G Ste 100, Austin, TX 78726 | 2013-02-04 |
| 1295974236 | Brendan Booker Loehr | Dentist | Britex Dental 10200 Boulder Lane, Suite 300, Austin, TX 78726 | 2009-02-16 |
| 1174730980 | David Eugene Helms | Counselor | 12112 Anderson Mill Rd, Bldg 12 Ste E, Austin, TX 78726 | 2007-05-17 |
| 1013037480 | Four Points Dental Pa | Dentist | 7301 North Fm 620, Suite 150, Austin, TX 78726 | 2007-03-30 |
| 1043329469 | H-e-b, Lp | Clinical Medical Laboratory | 7301 N Fm 620, Austin, TX 78726 | 2006-08-30 |
| 1063521037 | H-e-b, Lp | Clinical Medical Laboratory | 11521 North Fm 620 Building A, Austin, TX 78726 | 2006-08-30 |
| 1518934413 | Thomas Gretzinger | Dermatology | 12211 Fm 2769, Austin, TX 78726 | 2006-03-01 |
| Find all providers in zip 78726 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368591 | Tch Pediatrics Inc | Pediatrics | 4207 James Casey St Ste 111, Austin, TX 78745-3362 | 2020-08-28 |
| 1245858166 | Patricia Bailey Nicol | Pediatrics | 6101 E Oltorf St # Tx78741, Austin, TX 78741-7500 | 2020-07-07 |
| 1962061986 | Tch Pediatrics Inc | Pediatrics | 2911 Medical Arts St Ste 7, Austin, TX 78705-3302 | 2019-06-12 |
| 1316502875 | Tch Pediatric Associates, Inc | Pediatrics | 1111 W 34th St Ste 102, Austin, TX 78705-1916 | 2019-05-09 |
| 1871158816 | Sara Marie Dryden | Pediatrics | 4900 Mueller Blvd Ste 35.066c, Austin, TX 78723-3079 | 2019-05-06 |
| 1285190066 | Raegan Oneill | Pediatrics | 1621 E 6th St Apt 1230, Austin, TX 78702-3350 | 2019-02-16 |
| 1376023267 | Tch Pediatric Associates, Inc | Pediatrics | 2911 Medical Arts St Ste 20, Austin, TX 78705-3302 | 2018-08-20 |
| 1174012272 | Amanda Vela | Pediatrics | 4900 Mueller Blvd Ste 3s.066, Austin, TX 78723-3079 | 2018-05-03 |
| 1316434236 | Yasaman Ahmadieh | Pediatrics | 4900 Mueller Boulevard, Suite 3s.066c, Austin, TX 78723 | 2018-04-16 |
| 1083120257 | Rachel Aujla Quirt | Pediatrics | 1301 Barbara Jordan Blvd Ste 200b, Austin, TX 78723-3078 | 2017-12-23 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.