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General NPI Number Information
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NPI Number | 1588656409
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Entity Type | Individual
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Provider Name | NANCE D HICKS D0
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Gender | Female
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 805 N MAIN ST
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City | CLEBURNE
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State | TX
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Zip | 76033-3816
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Country | US
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Telephone | 817-202-3976
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Fax | 817-202-3978
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Provider Business Mailing Address
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Address Line | 1220 PALUXY MEDICAL CIR
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City | GRANBURY
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State | TX
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Zip | 76048-7901
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Country | US
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Telephone | 817-408-3320
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Fax | 817-408-3328
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R2620
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License Number State | TX
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