Provider Demographics
NPI:1588773246
Name:SICARD, PAUL BRETT (PT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:BRETT
Last Name:SICARD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7025 COVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7554
Mailing Address - Country:US
Mailing Address - Phone:603-933-2510
Mailing Address - Fax:
Practice Address - Street 1:6105 WINDCOM CT
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7889
Practice Address - Country:US
Practice Address - Phone:972-781-1111
Practice Address - Fax:972-781-1101
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2950OtherLICENSE #
TX1127322OtherPT LICENSE #