Individual
MARY ALICE SALLMAN HICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
560 MEYERLAND PLAZA MALL, HOUSTON, TX 77096-1615
(713) 442-3222
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-4997
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
T1099
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427148801
—
TX
05
—
427148802
—
TX
05
—
427148803
—
TX
Enumeration date
05/30/2017
Last updated
10/28/2021
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