MEDICARE: JIMMY L STICKLES MD

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	207P00000X	Emergency Medicine Physician	Q6793	TX
2	207P00000X	Emergency Medicine Physician	BP10050635	TX

General Provider Information

NPI Number	:	1952711079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIMMY L STICKLES MD

Provider Business Mailing Address
First Line	:	5219 CITY BANK PKWY STE 35
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79407-3545
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 N INTERSTATE 35
Second Line	:	SUITE C2.230
City	:	AUSTIN
State	:	TX
Zip	:	78701-1926
Country	:	US
Telephone Number	:	512-324-8221
Fax Number	:

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

Provider Enumeration Date	:	04/28/2014
Last Update Date	:	03/17/2026

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Directions to “ JIMMY L STICKLES MD” Practice Location

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