Individual
ELLEN MAMIE WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2000 TRANSMOUNTAIN RD STE B, EL PASO, TX 79911-3602
(915) 215-8400
(915) 215-8674
Mailing address
440 RAYNOLDS ST # 51015, EL PASO, TX 79905-1613
(915) 215-4480
(915) 215-5386
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
T6079
TX
208C00000X
Colon & Rectal Surgery Physician
Primary
T6079
TX
Other
Enumeration date
04/11/2016
Last updated
09/22/2023
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