Individual
DR. GREGG JEFFRY DIMMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 REGIONAL MEDICAL DR, WHARTON, TX 77488-9719
(979) 532-1700
(979) 532-6793
Mailing address
2100 REGIONAL MEDICAL DR, WHARTON, TX 77488-9719
(979) 532-1700
(979) 532-6793
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
F0169
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124957502
—
TX
05
—
124957507
—
TX
01
—
370002795
RAILROAD GBA - RAILROAD MEDICARE
TX
01
—
820622
BC/BS TX #
TX
01
—
8DE526
BC/BS #
TX
Enumeration date
04/06/2006
Last updated
10/30/2012
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