Provider Demographics
NPI:1699896548
Name:DOERING, NIKI (NIKI DOERING, LMT)
Entity type:Individual
Prefix:
First Name:NIKI
Middle Name:
Last Name:DOERING
Suffix:
Gender:F
Credentials:NIKI DOERING, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 SPIREA CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-4373
Mailing Address - Country:US
Mailing Address - Phone:512-288-7038
Mailing Address - Fax:
Practice Address - Street 1:3839 BEE CAVE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6401
Practice Address - Country:US
Practice Address - Phone:512-809-0310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMT 2567225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist