Individual provider · NPI-1

Mickey Hicks Sr.

Home Health Aide · Cedar Hill, TX

NPI number1023727930
StatusActive
Last updated in NPPESNov 18, 2022

Details

NPI
1023727930
Entity type
Individual (NPI-1)
Name
Mr. Mickey Hicks Sr.
Sex
Male
Sole proprietor
No
Enumeration date
Nov 18, 2022
Certification date
Nov 18, 2022
Last updated
Nov 18, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374U00000X Home Health Aide––Yes

Practice location

600 Renaissance Pl
Cedar Hill, TX 75104-1766

Phone 972-639-2866

Mailing address

Po Box 532
Hughes Springs, TX 75656-0532

Phone 972-639-2866

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