David C.S. Nickeson, M.D., P.a.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

DAVID C.S. NICKESON, M.D., P.A.

Practice address

6807 Emmett F Lowry Expy
Suite 303
Texas City, TX 77591-2546

Phone

(409) 935-2995

Fax

(409) 935-3433

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David C.S. Nickeson, M.D.

Title

President

Phone

(409) 935-2995

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mainland Pulmonary Associates Doing business as

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1407073646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6807 EMMETT F LOWRY EXPY",
            "address_2": "SUITE 303",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775912546",
            "telephone_number": "409-935-2995",
            "fax_number": "409-935-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6807 EMMETT F LOWRY EXPY",
            "address_2": "SUITE 303",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775912546",
            "telephone_number": "409-935-2995",
            "fax_number": "409-935-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C.S. NICKESON, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "NICKESON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C.S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-935-2995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169922501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mainland Pulmonary Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pulmonary Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.