Provider Demographics
NPI:1174986160
Name:HORTON, NICOLE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HORTON
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 1:20718 DICKINSON MANOR LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6524
Mailing Address - Country:US
Mailing Address - Phone:832-897-7814
Mailing Address - Fax:281-213-4691
Practice Address - Street 1:20718 DICKINSON MANOR LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6524
Practice Address - Country:US
Practice Address - Phone:832-897-7814
Practice Address - Fax:281-213-4691
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015230251E00000X
TX261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service