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Organization
MABELL'S PLACE
Active
Organization
MABELL'S PLACE
Active
Other names
ALICE HICKMAN
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ALICE MARIE HICKMAN NURSE (OWNER)
(254) 752-5434
Entity
Organization
Contact information
Practice address
1115 N 12TH ST, 1115 NORTH 12 STREET, WACO, TX 76707-3121
(254) 752-5434
(254) 752-4478
Mailing address
PO BOX 3525, 1115 NORTH 12 STREET, WACO, TX 76707-0525
(254) 752-5434
(254) 752-4478
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
126265
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000873000
—
TX
Enumeration date
10/03/2007
Last updated
10/03/2007
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