Corley, David Dickson
Corley, David Dickson is an individual health care provider with primary practice located at 1300 W Terrell Ave Ste 500 , Fort Worth TX 76104-2810. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Corley, David Dickson can be contacted via phone (817) 252-5000.Contact Information
Primary practice address
1300 W Terrell Ave Ste 500
Fort Worth TX 76104-2810
Phone: (817) 252-5000
Fax: (817) 252-5060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | H4251 | Texas |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | H4251 | Texas |
Profile Details
| NPI number | 1144217084 |
|---|---|
| LBN Legal business name | Corley, David Dickson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2005 |
| Last updated | Aug 18th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144217084 | NPPES |
| Texas | MEDICAID | 1253643-02 | |
| Texas | Other | 110188988 | |
| Texas | Other | 85K259 | |
| Texas | MEDICAID | 125364305 |
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