Sandra Dee Dickerson, MD
Surgery in Irving, TX. Individual provider (NPI-1).
NPI number1912964107
StatusActive
Last updated in NPPESJul 2, 2020
Details
- NPI
- 1912964107
- Entity type
- Individual (NPI-1)
- Name
- Sandra Dee Dickerson
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 1, 2006
- Certification date
- Jul 2, 2020
- Last updated
- Jul 2, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | J7469 | TX | Yes |
| 202K00000X | Phlebology | J7469 | TX | |
| 2083P0011X | Preventive Medicine, Undersea and Hyperbaric Medicine | J7469 | TX |
Practice location
400 W Interstate Hwy 635 Ste 130Irving, TX 75063-3700
Phone 972-579-5222 · Fax 972-579-3900
Mailing address
Po Box 224702Dallas, TX 75222-4702
Phone 972-579-5222 · Fax 972-579-3900
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