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NPI Code Detail

MEDICARE: DR. WILLIAM A RICKS D.D.S.

MEDICARE: DR. WILLIAM A RICKS D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry14562TX

General Provider Information

NPI Number : 1033175153
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM A RICKS D.D.S.
Provider Business Mailing Address
First Line : 2009 LOBELIA DR
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-5382
Country : US
Telephone Number : 512-918-8624
Fax Number :
Provider Business Practice Location Address
First Line : 2901 MONTOPOLIS DR
Second Line :
City : AUSTIN
State : TX
Zip : 78741-6411
Country : US
Telephone Number : 512-389-6529
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 07/08/2007

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