Individual
JERRY W DODSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
417 MONTECITO DR, SAN ANGELO, TX 76903-7342
(325) 659-1787
(325) 659-5501
Mailing address
417 MONTECITO DR, SAN ANGELO, TX 76903-7342
(325) 659-1787
(325) 659-5501
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
D8195
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098697802
—
TX
01
—
82-0368325
TAX ID
—
Enumeration date
08/10/2006
Last updated
07/08/2008
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