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Charles H Dickerson
Radiologic Technologist in Tyler, Texas
NPI 1699181842

Charles H Dickerson is a Radiologic Technologist based in Tyler, TX. Charles H Dickerson practices in Tyler, TX. The NPI Number for Charles H Dickerson is 1699181842 and holds a License No. 6309 (Texas).

The current practice location address for Charles H Dickerson is 2208 Old Henderson Hwy, Tyler, TX and can be reached out via phone at 903-596-9729 and via fax at 903-747-3373. You can also correspond with Charles H Dickerson through the mailing address at 2208 OLD HENDERSON HWY, TYLER, TX - 75702-6457 (mailing address contact number: 903-596-9729).

Location: 2208 Old Henderson Hwy, Tyler, TX, 75702-6457
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699181842
Provider Name
Charles H Dickerson
Credential
Provider Entity Type
Individual
Gender
Male
Address
2208 Old Henderson Hwy, Tyler, TX, 75702-6457
Phone Number
903-596-9729
Fax Number
903-747-3373
Provider Enumeration Date
07/09/2014
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
0860918-01 05 TX
institution
Provider Business Practice Location Address Details
Address
2208 Old Henderson Hwy
City
Tyler
State
Texas
Zip
75702-6457
Phone Number
903-596-9729
Fax Number
903-747-3373
person
Provider Business Mailing Address Details
Address
2208 Old Henderson Hwy
City
Tyler
State
Texas
Zip
75702-6457
Phone Number
903-596-9729
Fax Number
903-747-3373
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
-
Taxonomy
247100000X
License No.
6309 (Texas)
Definition
An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment.
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