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General NPI Number Information
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NPI Number | 1083837603
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Entity Type | Organization
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Legal Business Name | HICKS CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 6202 MCPHERSON RD SUITE 2
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City | LAREDO
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State | TX
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Zip | 78041-6182
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Country | US
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Telephone | 956-791-8686
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Fax | 956-791-8687
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Provider Business Mailing Address
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Address Line | 6202 MCPHERSON RD SUITE 2
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City | LAREDO
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State | TX
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Zip | 78041-6182
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Country | US
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Telephone | 956-791-8686
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Fax | 956-791-8687
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROLAND RUSSELL HICKS
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Credential | DC
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Telephone | 956-791-8686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 5560
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 5560
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | 5560
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5560
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License Number State | TX
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