Provider Demographics
NPI:1629080080
Name:HICKL, ANDREW GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GERARD
Last Name:HICKL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 SWISS AVE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6251
Mailing Address - Country:US
Mailing Address - Phone:214-828-5030
Mailing Address - Fax:214-828-5031
Practice Address - Street 1:3434 SWISS AVE
Practice Address - Street 2:SUITE 430
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6251
Practice Address - Country:US
Practice Address - Phone:214-828-5030
Practice Address - Fax:214-828-5031
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046193101Medicaid
TX87X764OtherBCBS
TX110169460Medicare PIN
TX87X764Medicare PIN
TX046193101Medicaid