Provider Demographics
NPI:1003835620
Name:BRICKEY, DAVID A (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:BRICKEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:903-531-5000
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-525-1914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2931207RP1001X, 207RS0012X, 207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164496505Medicaid
TX8AK460OtherBCBS INDIVIDUAL #
TX75-2616977-026OtherTRICARE
TX164496506Medicaid
TX164496503Medicaid
TX8DC861OtherBCBS
TXP01154594OtherRAIL ROAD
TX75-2616977-042OtherTRICARE
TX164496507Medicaid
TX75-2616977-123OtherTRICARE
TXP00881732OtherRAILROAD MEDICARE
TXH10855Medicare UPIN
TXP00881732OtherRAILROAD MEDICARE
TX164496506Medicaid
TX8F6808Medicare PIN
TX164496505Medicaid
TX270568YMAFMedicare PIN