Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 8137 | TX |
N | 111NI0013X | Independent Medical Examiner | 8137 | TX |
N | 111NN1001X | Nutrition | 8137 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 8137 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 8137 | TX |
NPI | 1295947661 |
---|---|
Provider Name | Dr. Brian Thomas Hickey |
First Address | Arlington, TX 76011-5044 |
Second Address | Arlington, TX 76011-5044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2007 |
Last Update Date | 08/07/2007 |