Provider Demographics
NPI:1124347638
Name:NICAS, MICHAELA (PT)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:NICAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 CYPRESSWOOD DR
Mailing Address - Street 2:STE 102
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7185
Mailing Address - Country:US
Mailing Address - Phone:281-376-3900
Mailing Address - Fax:281-376-7019
Practice Address - Street 1:8111 CYPRESSWOOD DR
Practice Address - Street 2:STE 102
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7185
Practice Address - Country:US
Practice Address - Phone:281-376-3900
Practice Address - Fax:281-376-7019
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist