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Organization

AVERESS DEAN RICKERSON

Active
Other names
A VICKI RICKERSON
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AVERESS DEAN RICKERSON MD (OWNER)
(210) 646-7227
Entity
Organization

Contact information

Practice address
8601 VILLAGE DR, 100, SAN ANTONIO, TX 78217-5509
(210) 646-7227
(210) 654-3575
Mailing address
8601 VILLAGE DR, 100, SAN ANTONIO, TX 78217-5509
(210) 646-7227
(210) 654-3575

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G7575
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
031773001
TX
Enumeration date
07/10/2008
Last updated
07/10/2008
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