DR. NICHOLE PORTEUS (NPI# 1326554056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326554056 |
| Entity Type | Individual |
| Full Name | DR. NICHOLE PORTEUS |
| Credential | DC |
| Practice Address |
771 E Southlake Blvd Ste 103 Southlake TX 76092-6354 |
| Mailing Address |
425 E Lamar Blvd Apt 167 Arlington TX 76011 |
| Practice Telephone | 4693697958 |
| Mailing Telephone | 3038757195 |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2020-09-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 12531 | TX | Chiropractic Providers |
| N | 111NP0017X |
Chiropractor Specialization: Pediatric Chiropractor |
12531 | TX | Chiropractic Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6103 Kenwood Ave, Dallas, TX 752143015 | 4693697958 |
| Street Address |
771 E SOUTHLAKE BLVD STE 103 |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092-6354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750842373 | Mary Beth Annas | Chiropractor | 590 N Kimball Ave Ste 140, Southlake, TX 76092-6888 | 2019-03-27 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1558852590 | Thomas Kramer | Chiropractor | 502 N Carroll Ave Ste 130, Southlake, TX 76092-6449 | 2018-05-25 |
| 1942797766 | Erb Family Wellness Southlake LLC | Chiropractor | 1845 E Southlake Blvd # 140, Southlake, TX 76092 | 2018-04-17 |
| 1689173320 | Richard David Thwaites | Chiropractor | 950 E State Highway 114 Ste 160-108, Southlake, TX 76092-5240 | 2018-02-08 |
| 1659734994 | Vb Creations, LLC | Chiropractor | 2225 W. Southlake Blvd, Suite#441, Southlake, TX 76092 | 2016-04-04 |
| 1134501802 | Lj3 Holdings, LLC | Chiropractor | 1800 East State Highway 114, Suite 101, Southlake, TX 76092-6529 | 2015-06-18 |
| 1104165323 | Gary Cagan Randall | Chiropractor | 100 W Southlake Blvd Ste 410, Southlake, TX 76092-6166 | 2013-02-07 |
| 1104191709 | Core Activated Rehab 2 LLC | Chiropractor | 1800 East Highway 114, Suite 101, Southlake, TX 76090 | 2012-03-14 |
| 1255600912 | Chiro One Wellness Center of South Lake Pllc | Chiropractor | 280 Commerce St, Ste F, Southlake, TX 76092-9100 | 2011-12-23 |
| Find all providers in SOUTHLAKE | ||||
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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.