KENNETH WILLIE DICKERSON NPI 1043744790

NPI Information

NPI: 1043744790
Provider Name: KENNETH WILLIE DICKERSON
Classification: Driver - 172A00000X
Entity Type: Individual
Address:
15530 ELLA BLVD APT 719
HOUSTON, TX
ZIP 77090
Phone: (832) 892-1079
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Kenneth Willie Dickerson is a driver in Houston, TX. The provider is a person employed to operate a motor vehicle as a carrier of persons or property. Kenneth Willie Dickerson NPI is 1043744790. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

15530 ELLA BLVD APT 719
HOUSTON, TX
ZIP 77090
Phone: (832) 892-1079

The enumeration date for this NPI number is 4/19/2017 and was last updated on 4/19/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	405300000X	Prevention Professional		24512126	TEXAS	No
2	172A00000X	Driver		24512126	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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