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NPI Code Detail

MEDICARE: LEVI HICKMAN LMT

MEDICARE:   LEVI  HICKMAN  LMT
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
1225700000XMassage Therapist26995021TX

General Provider Information

NPI Number : 1477854172
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEVI HICKMAN LMT
Provider Business Mailing Address
First Line : 8215 WESTCHESTER DR STE 221
Second Line :
City : DALLAS
State : TX
Zip : 75225-6116
Country : US
Telephone Number : 214-361-2772
Fax Number : 214-361-9968
Provider Business Practice Location Address
First Line : 8215 WESTCHESTER DR STE 221
Second Line :
City : DALLAS
State : TX
Zip : 75225-6116
Country : US
Telephone Number : 214-361-2772
Fax Number : 214-361-9968
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2010
Last Update Date : 11/11/2010

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Directions to “ LEVI HICKMAN LMT” Practice Location

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