Nicholas B. Creel, M.D., P.a.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

E1833 Issued in TX

Legal business name

NICHOLAS B. CREEL, M.D., P.A.

Doing business as

Nicholas B. Creel, M.D., P.A.

Practice address

215 Oak Dr S Ste a
Lake Jackson, TX 77566-5617

Phone

(979) 297-1241

Fax

(979) 297-5692

NPI assigned

Jan 30, 2012

Last updated

Jan 30, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathryn Ann Creel

Title

Office Manager

Phone

(979) 297-1241

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Nicholas B. Creel, M.D., P.A. Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1255603866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OAK DR S STE A",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665617",
            "telephone_number": "979-297-1241",
            "fax_number": "979-297-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OAK DR S STE A",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665617",
            "telephone_number": "979-297-1241",
            "fax_number": "979-297-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS B. CREEL, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "CREEL",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "979-297-1241"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TX",
            "license": "E1833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035580201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "00R280",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicholas B. Creel, M.D., P.A.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew C NG, DMD, MSD
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• Preferred Provider Organization in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Preferred Provider Organization in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.