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General NPI Number Information
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NPI Number | 1205856838
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Entity Type | Individual
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Provider Name | HENRYK J NIKICICZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 6701 DESERT CANYON DR
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City | EL PASO
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State | TX
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Zip | 79912-7604
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Country | US
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Telephone | 956-571-3272
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Fax |
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Provider Business Mailing Address
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Address Line | 6701 DESERT CANYON DR
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City | EL PASO
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State | TX
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Zip | 79912-7604
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Country | US
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Telephone | 956-571-3272
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | CDR0002497
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01090591A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | D0041086
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 3573-320
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | K2544
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License Number State | TX
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