Provider Demographics
NPI:1902457807
Name:HICKS, DANNY
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:HICKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2831 ELDORADO PKWY STE 103-385
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-7438
Mailing Address - Country:US
Mailing Address - Phone:425-999-6203
Mailing Address - Fax:
Practice Address - Street 1:1893 FM 1385 # 949
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-7611
Practice Address - Country:US
Practice Address - Phone:253-315-2355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider