Provider Demographics
NPI:1366198673
Name:WELCH, NICOLAS (DPM)
Entity type:Individual
Prefix:
First Name:NICOLAS
Middle Name:
Last Name:WELCH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634-0549
Mailing Address - Country:US
Mailing Address - Phone:254-675-8322
Mailing Address - Fax:254-675-2246
Practice Address - Street 1:201 POSEY AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634-1200
Practice Address - Country:US
Practice Address - Phone:254-675-8621
Practice Address - Fax:254-675-2254
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX692205213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist