Individual
MR. WINDEL DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
202 HOXIE, COUPLAND, TX 78615
(337) 348-6691
Mailing address
BOX 629, COUPLAND, TX 78615
(337) 348-6691
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20668
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87277A
BCBS
TX
01
—
P00322224
RR MEDICARE
TX
Enumeration date
05/16/2006
Last updated
11/02/2007
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