Individual
M. JOHN HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
504 MEDICAL CENTER BLVD, CONROE, TX 77304-2808
(713) 481-3544
(713) 432-0221
Mailing address
PO BOX 4677, HOUSTON, TX 77210-4677
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
J1685
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117408801
—
TX
Enumeration date
06/16/2005
Last updated
03/19/2009
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