MEDICARE: JOHN KIKER PA

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
1	363A00000X	Physician Assistant	PA01474	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770510976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN KIKER PA

Provider Business Mailing Address
First Line	:	5501 S EXPRESSWAY 77
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-3213
Country	:	US
Telephone Number	:	956-428-5522
Fax Number	:	956-421-2759

Provider Business Practice Location Address
First Line	:	500 E RIDGE RD
Second Line	:	STE 101
City	:	MCALLEN
State	:	TX
Zip	:	78503-1506
Country	:	US
Telephone Number	:	956-686-5226
Fax Number	:	956-618-3051

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	10/19/2016

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Directions to “ JOHN KIKER PA” Practice Location

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