Provider Demographics
NPI:1649847971
Name:DAGLIS, NICOLE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:DAGLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14930 MUESCHKE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-0980
Mailing Address - Country:US
Mailing Address - Phone:346-206-3992
Mailing Address - Fax:832-652-3626
Practice Address - Street 1:8665 NEW TRAILS DR STE 185
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-4272
Practice Address - Country:US
Practice Address - Phone:346-206-3992
Practice Address - Fax:832-652-3626
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111681-01104100000X
TX1073291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker