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General NPI Number Information
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NPI Number | 1699921825
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Entity Type | Organization
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Legal Business Name | CARL M HICKMAN DDS PA
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 15731 FM 2920
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City | TOMBALL
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State | TX
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Zip | 77377
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Country | US
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Telephone | 281-516-9919
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Fax | 281-516-1750
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Provider Business Mailing Address
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Address Line | 15731 FM 2920
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City | TOMBALL
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State | TX
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Zip | 77377
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Country | US
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Telephone | 281-516-9919
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Fax | 281-516-1750
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CARL M HICKMAN
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Credential | DDS
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Telephone | 281-516-9919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D13346
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License Number State | TX
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