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Dr. Kenneth I Licker , MD

Urology • Desoto, TX

Active NPI 1891781316 Individual Practitioner Male Practitioner
Practice location in NPPES

935 York Dr
Desoto, TX 751152043

Call 8177840818 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

935 York Dr

Desoto, TX 751152043

Telephone 8177840818
Fax 9727095920
Organization at the Same NPPES Address or Phone
Elite Women's Wellness Llc Facility NPI 1285414565

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2005

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Desoto and Texas

4 active clinicians are listed under Urology with a practice address in Desoto, TX (961 in Texas).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

License # reported to NPPES TX F7819

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Texas Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
114910602 (TX)
Medicaid ID
114910601 (TX)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
NPI 1568458958

Doctor of Medicine (M.D.)

Career & Practice History

NPI enumerated September 20, 2005.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1891781316
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 20, 2005
Last Update: October 09, 2009
Sole Proprietor: No

Other Urology Specialists in Desoto

Healthcare providers in Desoto

Mailing Address

Po Box 120549

Arlington, TX 760120549

Phone: 8173034521

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.