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Organization

HICO CLINIC, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BILLY CHARLES DAYTON MD (ADMINISTRATOR)
(254) 796-4224
Entity
Organization

Contact information

Practice address
104 WALNUT, HICO, TX 76457
(254) 796-4224
(254) 796-4064
Mailing address
PO BOX H, HICO, TX 76457-0230
(254) 796-4224
(254) 796-4064

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
673869
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
122918
CHIPS
TX
01
5561178
AETNA
TX
01
807884
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/15/2006
Last updated
01/28/2008
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