Provider Demographics
NPI:1386086163
Name:HOFF, NICOLE D (PA-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:D
Last Name:HOFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4057 RILEY FUZZEL RD STE 500-504
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4632
Mailing Address - Country:US
Mailing Address - Phone:956-245-1787
Mailing Address - Fax:
Practice Address - Street 1:4057 RILEY FUZZEL RD STE 500-504
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4632
Practice Address - Country:US
Practice Address - Phone:956-245-1787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X, 390200000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant