Provider Demographics
NPI:1720962301
Name:CARR, NICHOLAS (HIS)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:CARR
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10228 BROADWAY ST STE 108
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8088
Mailing Address - Country:US
Mailing Address - Phone:832-770-4474
Mailing Address - Fax:
Practice Address - Street 1:10228 BROADWAY ST STE 108
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8088
Practice Address - Country:US
Practice Address - Phone:832-770-4474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81241237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist