Organization
TICO TELEHEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA BIBBY (CEO)
(512) 775-5779
Entity
Organization
Contact information
Practice address
4624 FORT CROCKETT BLVD, GALVESTON, TX 77551
(512) 775-5779
Mailing address
7300 REMCON CIR STE 200, EL PASO, TX 79912-1647
(915) 532-3600
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120358001
—
TX
01
—
H9088
LICENSE
TX
Enumeration date
01/20/2017
Last updated
01/20/2017
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