Provider Demographics
NPI:1194058875
Name:BICKHAM, JOHN STEVEN
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:STEVEN
Last Name:BICKHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 PINECROFT DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2426
Mailing Address - Country:US
Mailing Address - Phone:281-494-8982
Mailing Address - Fax:281-494-0344
Practice Address - Street 1:1419 PINECROFT DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-2426
Practice Address - Country:US
Practice Address - Phone:281-494-8982
Practice Address - Fax:281-494-0344
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05501680343900000X, 347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)