David R. Ficklen, M.D., P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

K5929 Issued in TX

Legal business name

DAVID R. FICKLEN, M.D., P.A.

Doing business as

Turtle Creek Medical

Practice address

102 Medical Park LN Ste a
Huntsville, TX 77340-4975

Phone

(936) 435-0014

Fax

(936) 435-9108

NPI assigned

Apr 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David R Ficklen, M.D.

Title

Owner

Phone

(936) 435-0014

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Turtle Creek Medical Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1508086323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MEDICAL PARK LN STE A",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404975",
            "telephone_number": "936-435-0014",
            "fax_number": "936-435-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MEDICAL PARK LN STE A",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404975",
            "telephone_number": "936-435-0014",
            "fax_number": "936-435-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R. FICKLEN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "FICKLEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-435-0014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "K5929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1642985-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Turtle Creek Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Primary Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.