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Contact Information

DICKERSON DALLAS PAIN ON PA
1675 REPUBLIC PKWY STE 201
MESQUITE, TX75150-6902
 Phone: 972-850-9179
 Fax: 877-720-5614
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Rehabilitation

261QR0400X B4[14] Rehabilitation Agency
Indicates primary specialty

NPI Profile & details for DICKERSON DALLAS PAIN ON PA

NPI Number 1134681349
LBN Legal business name DICKERSON DALLAS PAIN ON PA
Authorized official DAVID JANWAY - (COO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/05/2019
Last updated 02/04/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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