Organization · NPI-2

A.Vicki Rickerson MD

Internal Medicine · San Antonio, TX

NPI number1235673633
StatusActive
Last updated in NPPESDec 5, 2016

Details

NPI
1235673633
Entity type
Organization (NPI-2)
Legal business name
A.Vicki Rickerson MD
Organization subpart
No
Enumeration date
Dec 5, 2016
Last updated
Dec 5, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineAP132396TXYes

Practice location

8601 Village Dr Ste 100
San Antonio, TX 78217-5509

Phone 210-646-7227 · Fax 210-654-3575

Mailing address

8601 Village Dr Ste 100
San Antonio, TX 78217-5509

Phone 210-646-7227 · Fax 210-654-3575

Authorized official

Averess Vicki Rickerson
Owner
2106467227

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