Provider Demographics
NPI:1174897409
Name:COLEMAN, NIDIA NICOLE
Entity type:Individual
Prefix:
First Name:NIDIA
Middle Name:NICOLE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 ELDRIDGE RD STE E
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3794
Mailing Address - Country:US
Mailing Address - Phone:281-907-9528
Mailing Address - Fax:281-869-3693
Practice Address - Street 1:126 ELDRIDGE RD STE E
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3794
Practice Address - Country:US
Practice Address - Phone:281-817-1238
Practice Address - Fax:281-869-3693
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
TX90602101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator