Provider Demographics
NPI:1457526048
Name:ORD, CELINE BICQUART (MD)
Entity Type:Individual
Prefix:
First Name:CELINE
Middle Name:BICQUART
Last Name:ORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CELINE
Other - Middle Name:
Other - Last Name:BICQUART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1008
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78667-1008
Mailing Address - Country:US
Mailing Address - Phone:830-257-3131
Mailing Address - Fax:830-257-3161
Practice Address - Street 1:753 S WASHINGTON ST BLDG D
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624
Practice Address - Country:US
Practice Address - Phone:830-990-4800
Practice Address - Fax:830-257-3161
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP42202085R0001X, 2085R0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program