Mabell'S Place

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

126265 Issued in TX

Legal business name

MABELL'S PLACE

Doing business as

ALICE HICKMAN

Practice address

1115 N 12TH St
1115 North 12 Street
Waco, TX 76707-3121

Phone

(254) 752-5434

Fax

(254) 752-4478

NPI assigned

Oct 3, 2007

Organization subpart

No

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

Authorized official

Name

Miss Alice Marie Hickman, NURSE

Title

Owner

Phone

(254) 752-5434

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ALICE HICKMAN Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tamala Norris, DHA, RN, BSN

  • Assisted Living Facility
  • Waco, TX
  • NPI 1851061493
  NPD (past)

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1770770703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3525",
            "address_2": "1115 NORTH 12 STREET",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767070525",
            "telephone_number": "254-752-5434",
            "fax_number": "254-752-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N 12TH ST",
            "address_2": "1115 NORTH 12 STREET",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767073121",
            "telephone_number": "254-752-5434",
            "fax_number": "254-752-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MABELL'S PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-752-5434",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "NURSE"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "126265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000873000",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALICE HICKMAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lynn'S la Vega Pharmacy, Inc
• Lynns la Vega Pharmacy Inc
• Justin Lyons, PTA
• M-R Medical Inc
• M&T Pharmacy Solutions, LLC
• Lucinda Mabry, NP
• Bryce Elizabeth Macatol
• Scott Mace, HIS
• Sheree L Mach, OTR
• Venessa Mae Machac, OD

• Licensed Vocational Nurse in Waco, TX
• Providers in Waco, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.