Dallas Diederich in Flint - Physician Assistant
Dallas Diederich - NPI 1982729216
Dallas Diederich is a Physician Assistant in Flint, Texas. Dallas Diederich practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Dallas Diederich is 1982729216. The last update date is 2015-08-07.
Dallas Diederich's current location address is 20208 State Highway 155 S, Flint, Texas. You can contact this provider via phone number 9038256222. The mailing address for Dallas Diederich is 20208 State Highway 155 S, Flint, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dallas Diederich |
|---|---|
| Address | 20208 State Highway 155 S, Flint, Texas |
| Phone Number | 9038256222 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1982729216 |
|---|---|
| Provider Enumeration Date | 2007-03-19 |
| Last Updated Date | 2015-08-07 |
Provider Mailing Address Detail
| Address | 20208 State Highway 155 S |
|---|---|
| City | Flint |
| State | Texas (TX) |
| Post Code | 757625600 |
| Phone Number | 9038256222 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA00509 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 202460603 | TX | -- | |
| 75-0818167-048 | TX | TRICARE | |
| 75-1976930-005 | TX | TRICARE | |
| 202460602 | TX | -- | |
| 75-0818167-044 | TX | TRICARE | |
| 75-0818167-015 | TX | TRICARE | |
| 752616977001 | TX | TRICARE | |
| 8689NN | TX | BCBS | |
| P01478958 | TX | RAIL ROAD MEDICARE | |
| 202460601 | TX | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Dallas Diederich?
The Dallas Diederich has been issued the NPI (National Provider Identifier) 1982729216 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Dallas Diederich is physically located?
The Dallas Diederich is situated at the following address: 20208 State Highway 155 S, Flint, TX 757625600.
What is Dallas Diederich's specialized field of practice, and what is the corresponding taxonomy classification code?
The Dallas Diederich's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
When did the Dallas Diederich receive its 1982729216?
The Dallas Diederich was issued its 1982729216 on 2007-03-19, which is the date when the organization was assigned this unique identifier.
When was the information pertaining to Dallas Diederich most recently updated or revised?
The details related to Dallas Diederich, including its address, specialty, and other relevant information, were last updated or revised on 2015-08-07.