Provider Demographics
NPI:1881629640
Name:FIKES, ORLAN LEE (DC)
Entity Type:Individual
Prefix:
First Name:ORLAN
Middle Name:LEE
Last Name:FIKES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:O
Other - Middle Name:L
Other - Last Name:FIKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:5309 WURZBACH RD
Mailing Address - Street 2:STE 114
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-2431
Mailing Address - Country:US
Mailing Address - Phone:210-684-8464
Mailing Address - Fax:210-684-8894
Practice Address - Street 1:5309 WURZBACH RD
Practice Address - Street 2:STE 114
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-2431
Practice Address - Country:US
Practice Address - Phone:210-684-8464
Practice Address - Fax:210-684-8894
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601119Medicare PIN