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NPI Code Detail

MEDICARE: SHYLISA HICKS NP

MEDICARE: SHYLISA HICKS NP
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
1163WN0002XNeonatal Intensive Care Registered Nurse929193TX
2208000000XPediatrics Physician1088788TX
3363LP0200XPediatric Nurse Practitioner1088788TX

General Provider Information

NPI Number : 1154964930
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHYLISA HICKS NP
Provider Business Mailing Address
First Line : 20403 FM 529 RD STE 200
Second Line :
City : CYPRESS
State : TX
Zip : 77433-5379
Country : US
Telephone Number : 281-656-4041
Fax Number :
Provider Business Practice Location Address
First Line : 20403 FM 529 RD STE 200
Second Line :
City : CYPRESS
State : TX
Zip : 77433-5379
Country : US
Telephone Number : 281-656-4041
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2019
Last Update Date : 01/13/2024

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