Individual ProviderNisha WanichwecharungruangStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address3601 4th Street, Stop 9410, Lubbock, TX 79430(806) 743-3641PECOS EnrollmentBased on the most recent information from CMS, provider Nisha Wanichwecharungruang does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1477344281Provider TypeIndividualFull NameWanichwecharungruang, NishaTitleMs.CredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date5/13/2025Last Updated5/13/2025Contact InformationPractice LocationPractice Address3601 4th Street, Stop 9410, Lubbock, TX 79430Phone(806) 743-3641FaxUnlisted FaxMailing LocationMailing Address3601 4th Street, Stop 9410, Lubbock, TX 79430Phone(806) 743-3641FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer