Derrick Lamont Dickerson
Technician, Other in Alto, TX. Individual provider (NPI-1).
NPI number1982568614
StatusActive
Last updated in NPPESDec 16, 2025
Details
- NPI
- 1982568614
- Entity type
- Individual (NPI-1)
- Name
- Derrick Lamont Dickerson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 16, 2025
- Certification date
- Dec 16, 2025
- Last updated
- Dec 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
221 Elm StAlto, TX 75925-2805
Phone 855-832-6727 · Fax 772-675-9100
Mailing address
221 Elm StAlto, TX 75925-2805
Phone 855-832-6727 · Fax 772-675-9100
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