Individual
SHAILAH HICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2112 FORUM PKWY, BEDFORD, TX 76021-6028
(817) 799-4600
Mailing address
4709 RINCON WAY, FORT WORTH, TX 76137-5673
(817) 683-5824
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2159876
TX
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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