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Individual

DR. MARK EDWARD DICKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3305 N CALAIS ST, SUITE # 100, SHERMAN, TX 75090-3110
(903) 957-0016
(903) 957-0038
Mailing address
3305 N CALAIS ST, SUITE # 100, SHERMAN, TX 75090-3110
(903) 957-0016
(903) 957-0038

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
19378
OK
208600000X
Surgery Physician
Primary
H6165
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
034452501
TX
05
100153640A
OK
Enumeration date
01/12/2006
Last updated
05/09/2012
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