Healthcare Provider Details

I. General information

NPI: 1295947661
Provider Name (Legal Business Name): BRIAN THOMAS HICKEY D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 ROAD TO SIX FLAGS ST E SUITE 103
ARLINGTON TX
76011-5044
US

IV. Provider business mailing address

1201 ROAD TO SIX FLAGS ST E SUITE 103
ARLINGTON TX
76011-5044
US

V. Phone/Fax

Practice location:
  • Phone: 817-461-2697
  • Fax: 817-801-5444
Mailing address:
  • Phone: 817-461-2697
  • Fax: 817-801-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8137
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number8137
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number8137
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number8137
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number8137
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: