Charles H. Dickerson

LBN: Charles H. Dickerson
Charles H. Dickerson is an health care organization with primary practice located at 2208 Old Henderson Hwy , Tyler TX 75702-6457. The organization recently has only one registered license in Ambulatory Health Care Facilities / Radiology, Mobile, which is considered as the primary health care specialty. Charles H. Dickerson can be contacted via phone (903) 596-9729, or through Dickerson, Charles H via phone (903) 596-9729.

Contact Information

Primary practice address
2208 Old Henderson Hwy Tyler TX 75702-6457
Phone: (903) 596-9729
Fax: (903) 596-7206
Website:
Map and Directions
Authorized official contact:
Name: Dickerson, Charles H RADIOLOGIC TECHNOLOG
Phone: (903) 596-9729

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Radiology, Mobile 261QR0208X 6309 Texas

Profile Details

NPI number 1578589503
LBN Legal business name Charles H. Dickerson
DBA Doing business as
Authorized official Dickerson, Charles H RADIOLOGIC TECHNOLOG
Entity Organization
Organization subpart 1 No
Enumeration date Jul 14th, 2006
Last updated Jun 30th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578589503 NPPES
Texas MEDICAID 0860918 01

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