National Provider Identifier Database

CHARLES H DICKERSON
Radiologic Technologist

A medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation.


Contact Information

CHARLES H DICKERSON
2208 OLD HENDERSON HWY
TYLER, TX75702-6457
Phone: 903-596-9729
Fax: 903-747-3373
Website:
Specialty Taxonomy Code
* Radiologic Technologist 247100000X

* Indicates primary specialty

NPI Profile & details for CHARLES H DICKERSON

NPI Number 1699181842
Credentials
Entity Individual
Enumeration date 07/09/2014
Last updated 07/09/2014 - About 12 years ago
Sole proprietor1 Yes
Identifiers
  • TX License #: 6309
  • TX Medicaid: 0860918-01
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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