Active NPI
Hickory Texas, P.a.
- Multi-Specialty Clinic/Center
- Lakewood, NJ
National Provider Identifier
1255220810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Multi-Specialty Clinic/Center
- Legal business name
- HICKORY TEXAS, P.A.
- Practice address
- 15 America Ave Unit 103
Lakewood, NJ 08701-4583 - Phone
- (732) 631-4358
- NPI assigned
- Jun 30, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel Olivero
- Title
- Owner
- Phone
- (732) 631-4358
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Primary |
Addresses
Primary practice location
15 America Ave Unit 103
Lakewood, NJ 08701-4583
Mailing address
15 America Ave Unit 103
Lakewood, NJ 08701-4583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
5540 N Lamar Blvd
Austin, TX 78751
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751241600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1751241600000",
"number": "1255220810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 AMERICA AVE UNIT 103",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087014583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 AMERICA AVE UNIT 103",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087014583",
"telephone_number": "732-631-4358"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HICKORY TEXAS, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2025-06-30",
"last_updated": "2025-06-30",
"certification_date": "2025-06-30",
"status": "A",
"authorized_official_last_name": "OLIVERO",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "732-631-4358"
},
"taxonomies": [
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.