Provider Demographics
NPI:1578051884
Name:HICKS, ARLISHA BULLARD (DDS)
Entity type:Individual
Prefix:MRS
First Name:ARLISHA
Middle Name:BULLARD
Last Name:HICKS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:ARLISHA
Other - Middle Name:JASMINE
Other - Last Name:BULLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1209 JASMINE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-5213
Mailing Address - Country:US
Mailing Address - Phone:832-876-9713
Mailing Address - Fax:
Practice Address - Street 1:24004 PORTER RANCH LN STE A4
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-8300
Practice Address - Country:US
Practice Address - Phone:713-510-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX372581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program