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Individual

DALERIE A. WILKERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
303 E OVERTON RD, BLUITT-FLOWERS HEALTH CENTER, DALLAS, TX 75216-5946
(214) 266-4200
(214) 266-4218
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1527
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143872302
TX
05
143872304
TX
05
143872305
TX
05
143872306
TX
05
143872307
TX
05
143872308
TX
05
143872309
TX
05
143872310
TX
05
143872311
TX
05
143872312
TX
05
143872313
TX
05
143872314
TX
01
8W8850
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/28/2005
Last updated
12/04/2012
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