Individual provider Active NPI

Nicole A. Wunderlich, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1811261514
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6701 Fannin St
Houston, TX 77030-2608
Phone
(832) 824-1000
NPI assigned
Feb 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

6701 Fannin St
Houston, TX 77030-2608

Mailing address

2450 Holcombe Blvd
Ste NB-34L
Houston, TX 77021-2039
Phone (832) 828-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120613000581 TX Practitioner - Physician Assistant 2062676562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Dec 17, 2025 Accepting new patients
Houston Orthopedic and Spine Physicians, Inc. Past Accepting new patients

Locations

17600 Interstate 45 S
Fl 8
Conroe, TX 77384

2450 Holcombe Blvd
Ste NB34L
Houston, TX 77021
Phone (713) 796-0003

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

101 W Expressway 83
McAllen, TX 78503
Phone (956) 661-9840

17580 Interstate 45 S
The Woodlands, TX 77384
Phone (936) 267-5000

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Interoperability endpoints

  • Direct secure messaging: nwunderlic@yourcarecommunity.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1811261514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 HOLCOMBE BLVD",
            "address_2": "STE NB-34L",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770212039",
            "telephone_number": "832-828-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUNDERLICH",
        "first_name": "NICOLE",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-28",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.