Provider Demographics
NPI:1962098715
Name:NICHOLAS, RINO
Entity type:Individual
Prefix:DR
First Name:RINO
Middle Name:
Last Name:NICHOLAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:649 PRESS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-8639
Mailing Address - Country:US
Mailing Address - Phone:985-414-1746
Mailing Address - Fax:
Practice Address - Street 1:7440 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3129
Practice Address - Country:US
Practice Address - Phone:281-852-8088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64009183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX64009OtherTEXAS STATE BOARD OF PHARMACY