Organization
DALLAS-FORT WORTH SPINE INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROB DICKERMAN DO (OWNER)
(972) 238-0512
Entity
Organization
Contact information
Practice address
6130 W PARKER RD STE 502, PLANO, TX 75093-7993
(972) 238-0512
(972) 378-6925
Mailing address
6130 W PARKER RD STE 502, PLANO, TX 75093-7993
(972) 238-0512
(972) 378-6925
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13219906
TEXAS DRIVERS LICENSE
TX
Enumeration date
07/11/2019
Last updated
07/11/2019
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