Organization
MARK S HICKMAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK S HICKMAN MD (PRESIDENT)
(830) 625-6259
Entity
Organization
Contact information
Practice address
598 N UNION AVE, SUITE 200, NEW BRAUNFELS, TX 78130-4179
(830) 625-6259
(830) 625-6607
Mailing address
598 N UNION AVE, SUITE 200, NEW BRAUNFELS, TX 78130-4179
(830) 625-6259
(830) 625-6607
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G3461
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D03K
BCBS
TX
01
—
020009056
MEDICARE RAILROAD
TX
05
—
120477801
—
TX
Enumeration date
06/24/2008
Last updated
10/12/2010
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