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

Nickolas Mundo

Individual provider Family Medicine Physician · NPI 1528754884

Nickolas Mundo is a Family Practice in Fort Worth, Texas. Qualified in 2023, 3 years ago. Practices with Concord Medical Group of Texas PLLC, a 317-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
3
Licensed in
TX
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4917
Phone: (817) 702-1100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence V3055 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1528754884
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 11, 2023
Last updated in NPPESJuly 16, 2025
Certification dateJuly 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Concord Medical Group Of Texas Pllc — 317 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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