Individual
MR. REVELL E HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT, MBA
Contact information
Practice address
2312 COMANCHE TRL, GRAND PRAIRIE, TX 75052-8595
(817) 652-2632
Mailing address
2312 COMANCHE TRL, GRAND PRAIRIE, TX 75052-8595
(817) 652-2632
Taxonomy
Speciality
Code
Description
License number
State
2279C0205X
Critical Care Registered Respiratory Therapist
Primary
24222
TX
Other
Enumeration date
07/31/2007
Last updated
10/11/2007
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