Organization
HICKORY TRAIL HOSPITAL, L.P.
Active
Other names
Hickory Trail Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE FILTON (VP)
(610) 768-3482
Entity
Organization
Contact information
Practice address
2000 OLD HICKORY TRL, DESOTO, TX 75115-2242
(972) 298-7323
Mailing address
2000 OLD HICKORY TRL, DESOTO, TX 75115-2242
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
MEDICARE PART B
—
Enumeration date
11/07/2017
Last updated
11/07/2017
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