Active NPI
Leon Milton Hicks, M.D.
- Pediatric Surgery Physician
- Beaumont, TX
National Provider Identifier
1750330429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- E0053
- Practice address
- 2955 Harrison St
Ste 201
Beaumont, TX 77702-1154 - Phone
- (409) 892-4561
- Fax
- (409) 892-1775
- NPI assigned
- May 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | E0053 | TX | Primary |
Addresses
Primary practice location
2955 Harrison St
Ste 201
Beaumont, TX 77702-1154
Mailing address
2955 Harrison St
Ste 201
Beaumont, TX 77702-1154
Phone (409) 892-4561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 8, 2016 through Feb 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E0053 | TX | MD | Pediatric Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750330429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2955 HARRISON ST",
"address_2": "STE 201",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777021154",
"telephone_number": "409-892-4561",
"fax_number": "409-892-1775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2955 HARRISON ST",
"address_2": "STE 201",
"city": "BEAUMONT",
"state": "TX",
"postal_code": "777021154",
"telephone_number": "409-892-4561",
"fax_number": "409-892-1775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "LEON",
"middle_name": "MILTON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "TX",
"license": "E0053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaumont, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.