| Charles Wayne Nichols Jr, PT | |
|
855 Montgomery St, Fort Worth, TX 76107-2553 | |
| (817) 735-3627 | |
| Not Available |
| Full Name | Charles Wayne Nichols Jr |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 855 Montgomery St, Fort Worth, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437355583 | NPI | - | NPPES |
| 036784902 | Medicaid | TX | |
| 875T14 | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1046365 (Texas) | Primary |
| Provider Name | University Of North Texas Health Science Center At Fort Worth |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1376645564 PECOS PAC ID: 6103717350 Enrollment ID: O20040324001382 |
| Provider Name | Blacketer Enterprises, Inc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1295046050 PECOS PAC ID: 4981884905 Enrollment ID: O20110209000108 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Wayne Nichols Jr, PT Po Box 99335, Fort Worth, TX 76199-0335 Ph: () - | Charles Wayne Nichols Jr, PT 855 Montgomery St, Fort Worth, TX 76107-2553 Ph: (817) 735-3627 |
Dr. Kenneth Lawrence Miller, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3500 Camp Bowie Blvd, Fort Worth, TX 76107 Phone: 817-735-5466 | |
Benjamin Cheevers, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4108 Boat Club Rd, Fort Worth, TX 76135 Phone: 817-370-9891 | |
Christina Thompson, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 6501 Harris Pkwy, Fort Worth, TX 76132 Phone: 817-370-9891 Fax: 817-370-9894 | |
Dennis J Curnyn, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4750 Bryant Irvin Rd N, Fort Worth, TX 76107 Phone: 817-923-9000 Fax: 817-923-9033 | |
Marcia G Mckay, L.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3840 Hulen St, Htn, Client Accounting, Fort Worth, TX 76107 Phone: 817-569-4395 Fax: 817-569-4517 | |
Lacey Jo Hope, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5316 Trail Lake Dr, Fort Worth, TX 76133 Phone: 817-292-8787 Fax: 817-789-6849 | |
Mr. Cody Gohlke, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4625 Boat Club Rd, Fort Worth, TX 76135 Phone: 817-238-9295 Fax: 817-238-9299 |