Individual
PAUL H WICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1909 RICKETY LN, TYLER, TX 75703-1702
(903) 561-1840
Mailing address
PO BOX 9817, TYLER, TX 75711-2817
(903) 561-1840
(903) 561-4140
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
C9183
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102801102
—
TX
Enumeration date
02/23/2006
Last updated
05/24/2012
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