| Hickory Texas, P.a. | |
|
15 America Ave Unit 103 Lakewood NJ 08701-4583 | |
| (732) 631-4358 | |
| Not Available |
| Full Name | Hickory Texas, P.a. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 15 America Ave Unit 103, Lakewood, New Jersey |
| Authorized Official Name and Position | Daniel Olivero (OWNER) |
| Authorized Official Contact | 7326314358 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hickory Texas, P.a. 15 America Ave Unit 103 Lakewood NJ 08701-4583 Ph: () - | Hickory Texas, P.a. 15 America Ave Unit 103 Lakewood NJ 08701-4583 Ph: (732) 631-4358 |
| NPI Number | 1255220810 |
|---|---|
| Provider Enumeration Date | 06/30/2025 |
| Last Update Date | 06/30/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255220810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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