Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS11881 | FL |
N | 207Q00000X | Family Doctor | OS11881 | FL |
N | 207Q00000X | Family Doctor | Q4222 | TX |
NPI | 1285992685 |
---|---|
Provider Name | Dr. Nicole Elaine Myers |
First Address | Sugar Land, TX 77479-3868 |
Second Address | Bradenton, FL 34203-9712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 13/06/2019 |