Provider Demographics
NPI:1548415730
Name:DICKY HUEY M. D. P. A.
Entity type:Organization
Organization Name:DICKY HUEY M. D. P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-415-4172
Mailing Address - Street 1:8711 VILLAGE DR
Mailing Address - Street 2:#320
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5418
Mailing Address - Country:US
Mailing Address - Phone:210-872-4106
Mailing Address - Fax:210-297-2259
Practice Address - Street 1:540 MADISON OAK
Practice Address - Street 2:#340
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3943
Practice Address - Country:US
Practice Address - Phone:210-495-5300
Practice Address - Fax:210-297-2259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD41642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099599502Medicaid
TX099599502Medicaid
TX00N907Medicare PIN