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1811983174
AMY L NICHOLAS
GRAPEVINE, TX
NPI
1811983174
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Former Name
AMY L HICKS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: TX PA03950)
Enumeration Date
2005-09-22
Last Update Date
2020-08-26
Business Address
AMY L NICHOLAS PA
1650 W NORTHWEST HWY STE 200
GRAPEVINE, TX 76051-8122
Phone number: 972-716-3922
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Mailing Address
AMY L NICHOLAS PA
3139 SOUTHLAKE PARK RD
SOUTHLAKE, TX 76092-2501
Phone number: 214-668-6575
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