Individual
DANIEL E HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
12412 JUDSON RD, LIVE OAK, TX 78233-3255
(210) 757-5034
(210) 510-7260
Mailing address
1023 MORNING GLN, SPRING BRANCH, TX 78070-4955
(801) 870-8921
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12808
TX
363AM0700X
Medical Physician Assistant
PA21937
CA
Other
Enumeration date
09/26/2011
Last updated
07/08/2020
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