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Organization
JESSIE D. HICKS, D.O.,P.A.
Active
Organization
JESSIE D. HICKS, D.O.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSIE DENEICE HICKS D.O. (OWNER/PHYSICIAN)
(940) 552-9323
Entity
Organization
Contact information
Practice address
4301 COLLEGE DR RM 800, VERNON, TX 76384-3128
(940) 552-9323
(940) 552-9328
Mailing address
4301 COLLEGE DR RM 800, VERNON, TX 76384-3128
(940) 552-9323
(940) 552-9328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K6864
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0028DT
BLUE LINK
TX
05
—
030891801
—
TX
01
—
110243367
RAILROAD MEDICARE
TX
Enumeration date
08/01/2008
Last updated
08/01/2008
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