Individual
AVERESS DEAN RICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
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
07/21/2006
Last updated
06/17/2008
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