Provider Demographics
NPI:1366425589
Name:BRASSELL, NICOLE STARK (OD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:STARK
Last Name:BRASSELL
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:11607 CANYON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-7646
Mailing Address - Country:US
Mailing Address - Phone:713-459-2278
Mailing Address - Fax:281-251-8139
Practice Address - Street 1:10130 LOUETTA RD.
Practice Address - Street 2:B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-2116
Practice Address - Country:US
Practice Address - Phone:713-459-2278
Practice Address - Fax:281-897-9026
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2024-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX05713TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist