Individual
MR. JEFFRY ALAN DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3903 WISEMAN BLVD, STE 311, SAN ANTONIO, TX 78251-4422
(210) 615-1901
(210) 615-1905
Mailing address
P.O. BOX 117614, CARROLLTON, TX 75011-4422
(210) 615-1901
(210) 615-1905
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP118266
TX
363LF0000X
Family Nurse Practitioner
AP118266
TX
Other
Enumeration date
01/13/2011
Last updated
06/14/2021
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