Provider Demographics
NPI:1992828404
Name:STRATSO, NICHOLAS (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:STRATSO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-0508
Mailing Address - Country:US
Mailing Address - Phone:940-390-6787
Mailing Address - Fax:940-458-7745
Practice Address - Street 1:1600 W CHAPMAN DR
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266-9054
Practice Address - Country:US
Practice Address - Phone:940-458-2044
Practice Address - Fax:940-458-7745
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT31365Medicare UPIN
TX603956Medicare PIN