Provider Demographics
NPI:1962769588
Name:SIKES, AMY RICHELLE (MD,)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RICHELLE
Last Name:SIKES
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
Mailing Address - Street 2:3601 4TH STREET, STOP 8143
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0001
Mailing Address - Country:US
Mailing Address - Phone:806-743-2757
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
Practice Address - Street 2:3601 4TH STREET, STOP 8143
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0001
Practice Address - Country:US
Practice Address - Phone:806-743-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10043367207Q00000X
TXP8733207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine