Dickerson, Samuel Wendell

Dickerson, Samuel Wendell is an individual health care provider with primary practice located at 700 Scott And White Dr , College Station TX 77845-6441. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Dickerson, Samuel Wendell can be contacted via phone (979) 207-0100.

Contact Information

Primary practice address
700 Scott And White Dr College Station TX 77845-6441
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X BP1-0022044 Texas
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X M9971 Texas

Profile Details

NPI number 1467656025
LBN Legal business name Dickerson, Samuel Wendell
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2007
Last updated Jul 14th, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467656025 NPPES
Other 2790064977 MYUTMB 2790064977-COMMERCIAL NUMBER

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