| Lori Hickson, Md Pa | |
|
1619 E. Common St., Bldg. L Suite 1201 New Braunfels TX 78130 | |
| (830) 203-6695 | |
| (830) 214-6292 |
| Full Name | Lori Hickson, Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1619 E. Common St., Bldg. L, New Braunfels, Texas |
| Authorized Official Name and Position | Lori A Hickson (OWNER) |
| Authorized Official Contact | 8302036695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lori Hickson, Md Pa 1619 E. Common St., Bldg. L Suite 1201 New Braunfels TX 78130-3464 Ph: (830) 203-6695 | Lori Hickson, Md Pa 1619 E. Common St., Bldg. L Suite 1201 New Braunfels TX 78130 Ph: (830) 203-6695 |
| NPI Number | 1073875985 |
|---|---|
| Provider Enumeration Date | 06/15/2012 |
| Last Update Date | 03/18/2024 |
| Medicare PECOS PAC ID | 9032366612 |
|---|---|
| Medicare Enrollment ID | O20120904000793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073875985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | P2259 (Texas) | Primary |
| Provider Name | Lori Hickson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235196163 PECOS PAC ID: 3072637990 Enrollment ID: I20120905000170 |
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