Individual
DR. MARK S HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
598 N UNION AVE, SUITE 200, NEW BRAUNFELS, TX 78130-4136
(830) 625-6259
(830) 625-6607
Mailing address
598 N UNION AVE, SUITE 200, NEW BRAUNFELS, TX 78130-4179
(830) 625-6259
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G3461
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D03K
BCBS OF TEXAS
TX
01
—
020009056
MEDICARE RAILROAD
TX
05
—
120477801
—
TX
01
—
7425494727813000000
TRICARE
TX
Enumeration date
08/31/2006
Last updated
10/12/2010
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