Doctor Name: | MR. JOE PETE DICKINSON |
NPI Number: | 1134376213 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-C |
License Number: | 720595 |
Business Practice Address: | 111 N Johnson St Farmersville, TX - 754422103 |
Business Phone Number: | 9034543025 |
Business Fax Number: | 9034501408 |
Mailing Address: | Po Box 1908, GREENVILLE |
State: | TX |
Postal Code: | 754031908 |
Phone Number: | 9034543025 |
Fax Number: | 9034501408 |
NPI Enumeration Date: | 08/20/2008 |
NPI Last Update Date: | 04/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 720595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |