IndividualActive
Amy Nicholas, PA
NPI 1811983174 · Medical Physician Assistant · Grapevine, TX
Provider details
- NPI number
- 1811983174
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- PA03950 (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1650 W Northwest Hwy Ste 200
Grapevine, TX 76051-8122
Phone: (972) 716-3922
Fax: (214) 948-5516
Approximate (ZIP-level) locationGet directions
Mailing address
3139 Southlake Park Rd
Southlake, TX 76092-2501
Additional practice locations (2)
- 4000 Five Points Dr Ste 169Arlington, TX 76018-6057Phone: (972) 556-6946
- 5407 Basswood Blvd Ste 113Fort Worth, TX 76137-4499Phone: (972) 556-6946
Registry dates
- Enumerated
- 2005-09-22
- Last updated
- 2020-08-26
- Certified
- 2020-08-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.