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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1841187499

Nicolas Austin Broadway is a Student in an Organized Health Care Education/Training Program in Mansfield, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

1660 E Broad St
Mansfield, TX 76063-7381
Phone: (682) 503-7408
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 41645 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1841187499
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 18, 2025
Last updated in NPPESJuly 7, 2025
Certification dateJuly 7, 2025
Mailing address1613 Windcastle Dr, Mansfield, TX 76063-7928

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