| A Vicki Rickerson | |
|
8601 Village Dr 100 San Antonio TX 78217-5509 | |
| (210) 646-7227 | |
| (210) 654-3575 |
| Full Name | A Vicki Rickerson |
|---|---|
| Speciality | Internal Medicine |
| Location | 8601 Village Dr, San Antonio, Texas |
| Authorized Official Name and Position | Averess Dean Rickerson (OWNER) |
| Authorized Official Contact | 2106467227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Vicki Rickerson 8601 Village Dr 100 San Antonio TX 78217-5509 Ph: (210) 646-7227 | A Vicki Rickerson 8601 Village Dr 100 San Antonio TX 78217-5509 Ph: (210) 646-7227 |
| NPI Number | 1619131463 |
|---|---|
| Provider Enumeration Date | 07/10/2008 |
| Last Update Date | 07/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619131463 | NPI | - | NPPES |
| 031773001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G7575 (Texas) | Primary |
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