Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | MD435635 | PA |
N | 207N00000X | Dermatologist | N3082 | TX |
N | 207ND0900X | Dermatopathologist | MD435635 | PA |
Y | 207ND0900X | Dermatopathologist | N3082 | TX |
NPI | 1194983346 |
---|---|
Provider Name | Dr. Ryan Walter Hick |
First Address | Dallas, TX 75247-4915 |
Second Address | Dallas, TX 75247-4915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2008 |
Last Update Date | 29/07/2010 |