Individual
DR. DICKSON O ODERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 MEDICAL CENTER BLVD, A, LUFKIN, TX 75904-3173
(936) 632-4282
Mailing address
PO BOX 153701, LUFKIN, TX 75915-3701
(936) 632-4282
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
F3265
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00ET90
BLUE CROSS BLUE SHIELD
TX
05
—
114579901
—
TX
01
—
742080151759040000
TRI CARE
—
Enumeration date
01/16/2007
Last updated
01/13/2018
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