CHARLES H DICKERSON (NPI# 1699181842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699181842 |
| Entity Type | Individual |
| Full Name | CHARLES H DICKERSON |
| Practice Address |
2208 Old Henderson Hwy Tyler TX 75702-6457 |
| Practice Telephone | 9035969729 |
| Practice Fax Number | 9037473373 |
| Mailing Telephone | 9035969729 |
| Mailing Fax Number | 9037473373 |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | 6309 | TX | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 0860918-01 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962433748 | Charles Wayne Dickerson | Family Medicine | 1601 Brookwood Ave, Duncan, OK 73533-1360 | 2006-07-06 |
| 1982174223 | Charles Dickerson | Case Manager/Care Coordinator | 7240 Crowder Blvd Ste 202, New Orleans, LA 70127-1920 | 2018-11-29 |
| 1558701292 | Charles Earl Dickerson Jr. | Registered Nurse | 2005 Knight Lane Bldg H, Navmedsupcom Attn: Med Staff Services, Jacksonville, FL 32212-0140 | 2013-06-26 |
| Street Address |
2208 OLD HENDERSON HWY |
| City | TYLER |
| State | TX |
| Zip Code | 75702-6457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578589503 | Charles H. Dickerson | Clinic/Center | 2208 Old Henderson Hwy, Tyler, TX 75702-6457 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003981465 | Tyler Radiology Associates | Radiologic Technologist | 3200 Troup Hwy Ste 340, Tyler, TX 75701-8343 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467087049 | Alaa Mohamed | Radiologic Technologist | 8330 Lyndon B Johnson Fwy Ste B302, Dallas, TX 75243-1166 | 2020-03-04 |
| 1346882628 | 247 Mobile X-ray Services LLC | Radiologic Technologist | 10407 Shanley Landing Ct, Richmond, TX 77407-2727 | 2019-10-08 |
| 1205308707 | Dax Eli Wagner | Radiologic Technologist | 815 Hanks St, Lufkin, TX 75904-4961 | 2018-12-20 |
| 1578041828 | Sarah Nichole Northcutt | Radiologic Technologist | 12517 Nicholas Pl, Rhome, TX 76078-6064 | 2018-07-30 |
| 1649779448 | Rafael Rodriguez | Radiologic Technologist | 11365 Montwood Dr Ste A, El Paso, TX 79936-3867 | 2018-02-07 |
| 1568997559 | Gregory Abdullah | Radiologic Technologist | 134 E Mistletoe Ave, San Antonio, TX 78212-3407 | 2017-04-27 |
| 1093261604 | Julio Alcala | Radiologic Technologist | 10291 Pellicano Suite 102, El Paso, TX 79935 | 2016-09-01 |
| 1700339959 | Nina Tokpawhiea | Radiologic Technologist | 9900 Adleta Blvd Apt 711, Dallas, TX 75243-9211 | 2016-07-24 |
| 1780058032 | Daniel Benard Suniga | Radiologic Technologist | 2250 Holly Hall St Apt 345, Houston, TX 77054-3941 | 2015-11-24 |
| 1104292119 | William Lewis Snyder Jr. | Radiologic Technologist | 551 Renee Ln, Desoto, TX 75115-5161 | 2015-08-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CHARLES H DICKERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.