Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Nicholas Matthew Wisdom, PHD

Individual provider Clinical Neuropsychologist · NPI 1912260779

Dr. Nicholas Matthew Wisdom, PHD is a Clinical Neuropsychologist in League City, Texas. Licensed in Florida, Louisiana and Texas. Registered with an NPI since 2012.

Licensed in
FL, LA, TX
In the registry since
2012
Specialties on file
6
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

See every abbreviation used in this directory →

Practice location Address checks out

112 Magnolia Estates Dr
League City, TX 77573-4719
Phone: (888) 606-0086
Fax: (346) 223-0296
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 37585 (TX)
Clinical Neuropsychologist Taxonomy 103G00000X · Licence PY10489 (FL)
Clinical Psychologist Taxonomy 103TC0700X · Licence 37585 (TX)
Clinical Neuropsychologist Taxonomy 103G00000X · Licence 1549 (LA)
Clinical Psychologist Taxonomy 103TC0700X · Licence PY10489 (FL)
Clinical Psychologist Taxonomy 103TC0700X · Licence 1549 (LA)

Record details

NPI number1912260779
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJune 18, 2012
Last updated in NPPESMay 6, 2026
Certification dateMay 6, 2026
Mailing address112 Magnolia Estates Dr, League City, TX 77573-4719

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