Individual
DAVID R FICKLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 MEDICAL PARK LN STE A, HUNTSVILLE, TX 77340-4975
(936) 435-0014
(936) 435-9108
Mailing address
102 MEDICAL PARK LN STE A, HUNTSVILLE, TX 77340-4975
(936) 435-0014
(936) 435-9108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K5929
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047959403
—
TX
01
—
8M5490
BCBS
—
Enumeration date
06/22/2005
Last updated
05/18/2011
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