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General NPI Number Information
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NPI Number | 1124021381
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Entity Type | Individual
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Provider Name | RICKY DALE HENDRIX M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 201 4TH ST STE 5A
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8421
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Country | US
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Telephone | 318-483-1961
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Fax | 318-483-1964
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Provider Business Mailing Address
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Address Line | PO BOX 1334
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City | WINNFIELD
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State | LA
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Zip | 71483-1334
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Country | US
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Telephone | 318-628-5565
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Fax | 318-628-5950
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD.016338
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD.016338
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License Number State | LA
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