Kenneth I Licker, MD

NPI #1891781316 in Desoto, Texas

Provider Information

NPI Number
1891781316
Entity Type
Individual
Name
Kenneth I Licker, MD
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Urology
Credential
MD
Enumeration Date
Sep 20, 2005
Last Updated
Oct 9, 2009

Practice Location

Address
935 YORK DR
City
Desoto
State
Texas
ZIP Code
75115-2043
Phone
(817) 784-0818

Specialties & Taxonomy Codes

Specialty
Urology

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