Individual
JESSE DISHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14590 MIDWAY RD STE 100, DALLAS, TX 75244-3109
(972) 510-7707
(972) 767-0071
Mailing address
14590 MIDWAY RD STE 100, DALLAS, TX 75244-3109
(972) 510-7707
(972) 767-0071
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
3-20561-9801-6
TX
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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