Provider Demographics
NPI:1851706030
Name:HICKS, TERRILYN (BUSINESS OWNER)
Entity Type:Individual
Prefix:
First Name:TERRILYN
Middle Name:
Last Name:HICKS
Suffix:
Gender:F
Credentials:BUSINESS OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2686 MURWORTH DR APT 601
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1611
Mailing Address - Country:US
Mailing Address - Phone:832-673-1262
Mailing Address - Fax:
Practice Address - Street 1:2727 SPRING PLACE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-5218
Practice Address - Country:US
Practice Address - Phone:832-452-3640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health