Provider Demographics
NPI:1245520295
Name:BRICKEY, PRISCILLA HOGE
Entity type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:HOGE
Last Name:BRICKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:PRISCILLA
Other - Middle Name:DENISE
Other - Last Name:HOGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LM,CPM
Mailing Address - Street 1:19582 FM 95 S
Mailing Address - Street 2:
Mailing Address - City:MOUNT ENTERPRISE
Mailing Address - State:TX
Mailing Address - Zip Code:75681-4273
Mailing Address - Country:US
Mailing Address - Phone:713-562-0105
Mailing Address - Fax:512-883-2718
Practice Address - Street 1:14611 WHISPERING CYPRESS DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-6755
Practice Address - Country:US
Practice Address - Phone:713-562-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT0022300174400000X, 225700000X
TX12644374J00000X
TX99456176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174400000XOther Service ProvidersSpecialist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula