Provider Demographics
NPI:1376591552
Name:BICKEL, BRIAN ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ROBERT
Last Name:BICKEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E CENTRAL TEXAS EXPY
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-1883
Mailing Address - Country:US
Mailing Address - Phone:254-554-3636
Mailing Address - Fax:
Practice Address - Street 1:410 E CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1883
Practice Address - Country:US
Practice Address - Phone:254-554-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0021839122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist