Provider Demographics
NPI:1205856838
Name:NIKICICZ, HENRYK J (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRYK
Middle Name:J
Last Name:NIKICICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5802 SAGE RIVER CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8979
Mailing Address - Country:US
Mailing Address - Phone:281-344-1166
Mailing Address - Fax:281-344-1166
Practice Address - Street 1:5802 SAGE RIVER CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8979
Practice Address - Country:US
Practice Address - Phone:281-344-1166
Practice Address - Fax:281-344-1166
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COCDR0002497207L00000X
IN01090591A207L00000X
TXK2544207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE78884Medicare UPIN