Individual
DR. JESSIE JAMES DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5615 DEAUVILLE BLVD, STE 220, MIDLAND, TX 79706-2870
(432) 686-0321
(432) 686-0664
Mailing address
5615 DEAUVILLE BLVD, STE 220, MIDLAND, TX 79706-2870
(432) 686-0321
(432) 686-0664
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
15765
NV
207X00000X
Orthopaedic Surgery Physician
A135648
CA
207X00000X
Orthopaedic Surgery Physician
Primary
P6377
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215254156
NPI
TX
01
—
P6377
STATE LICENSE
TX
Enumeration date
05/03/2010
Last updated
09/08/2020
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