Individual
CHARLES H DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2208 OLD HENDERSON HWY, TYLER, TX 75702-6457
(903) 596-9729
(903) 747-3373
Mailing address
2208 OLD HENDERSON HWY, TYLER, TX 75702-6457
(903) 596-9729
(903) 747-3373
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
6309
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0860918-01
—
TX
Enumeration date
07/09/2014
Last updated
07/09/2014
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