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KENNETH I LICKER MD
NPI 1891781316
Urology in Desoto, TX

Active since September 20, 2005
935 YORK DR, DESOTO, TX 75115(817) 784-0818(972) 709-5920 Get Directions Write a Review

NPPES record last updated: October 9, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kenneth I Licker Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH I LICKER MD (NPI 1891781316) is an individual urology provider in Desoto, Texas, licensed in Texas (F7819) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1891781316
Entity TypeIndividualMale
Primary Taxonomy208800000X
Provider Legal NameKENNETH I LICKERCredential: MD
Location Address935 YORK DRDesoto, TX 75115-2043
Mailing AddressPo Box 120549Arlington, TX 76012-0549 · (817) 303-4521 · Fax (972) 709-5920
Phone(817) 784-0818
Fax(972) 709-5920
Sole ProprietorNo
Enumeration DateSeptember 20, 2005
Last NPPES UpdateOctober 9, 2009
✔ NPI 1891781316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
License✔ Licensed in TX · F7819
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
935 YORK DR, Desoto, TX 75115
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Other Identifiers 5

Medicaid114910601TX
Medicaid114910602TX
Medicare PIN8036J2TX
Medicare PIN83Z808TX
Medicare UPINB24376TX

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHIAMAKA AMANDA ORIZU
Nurse Practitioner (Family)
935 YORK DR
DESOTO, TX 75115
Dallas County (930) 232-4376
ELITE WOMEN'S WELLNESS LLC
Obstetrics & Gynecology
935 YORK DR
DESOTO, TX 75115
Dallas County (972) 296-4777
AMBER GAIL SKACH FNP
Nurse Practitioner
935 YORK DR
DESOTO, TX 75115
Dallas County (972) 571-3421
TAMIKA L PERRY D.O.
Family Medicine
935 YORK DR
DESOTO, TX 75115
Dallas County (972) 591-0954
HARESHKUMAR D BOGHARA M.D.
Family Medicine
935 YORK DR
DESOTO, TX 75115
Dallas County (972) 777-6956

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Licker's NPI number?

The NPI number for Kenneth Licker is 1891781316. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Where is Kenneth Licker located?

Kenneth Licker practices at 935 York Dr, Desoto, TX 75115. The listed phone number is (817) 784-0818.

What is Kenneth Licker's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

When was this NPI record last updated?

The NPPES record for Kenneth Licker was last updated on October 9, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.