Individual
DR. STEVEN L. HICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
935 S BAXTER AVE, STE 103, TYLER, TX 75701-2245
(903) 592-4473
(903) 592-4474
Mailing address
PO BOX 131629, TYLER, TX 75713-1629
(903) 592-4473
(903) 592-4474
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
H6286
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133135708
—
TX
Enumeration date
07/28/2005
Last updated
10/16/2007
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