Dickerson, Kenneth Willie

Dickerson, Kenneth Willie is an sole proprietor health care provider with primary practice located at 15530 Ella Blvd Apt 719 , Houston TX 77090. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Driver, Other Service Providers / Prevention Professional. Other Service Providers / Driver is his primary health care specialty. Dickerson, Kenneth Willie can be contacted via phone (832) 892-1079.

Contact Information

Primary practice address
15530 Ella Blvd Apt 719 Houston TX 77090
Phone: (832) 892-1079
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X 24512126 Texas
Other Service Providers / Prevention Professional 405300000X 24512126 Texas

Profile Details

NPI number 1043744790
LBN Legal business name Dickerson, Kenneth Willie
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 19th, 2017
Last updated Apr 19th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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