Individual
RICHARD DICKERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1411 N BECKLEY AVE, PAV III, SUITE 268, DALLAS, TX 75203-1259
(214) 947-4400
(214) 947-4436
Mailing address
1411 N BECKLEY AVE, PAV III, SUITE 268, DALLAS, TX 75203-1259
(214) 947-4400
(214) 947-4436
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E7053
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8DF390
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
06/12/2006
Last updated
06/27/2012
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