Individual
BRETT ALAN TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1801 N ED CAREY DR STE C, HARLINGEN, TX 78550-8281
(956) 428-8951
(956) 428-0232
Mailing address
PO BOX 532127, HARLINGEN, TX 78553
(956) 428-8951
(956) 428-0232
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1115756
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
087766401
—
TX
01
—
86657T
BCBS
—
Enumeration date
07/31/2006
Last updated
03/05/2009
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