Dr. Jeremy Lee Dickerson
Family Doctor Family Doctor - Sports Medicine
1139 E Sonterra Blvd Ste 205
San Antonio
, Texas 78258-4349
Dr. Jeremy Lee Dickerson
Family Doctor Family Doctor - Sports Medicine
1139 E Sonterra Blvd Ste 205
San Antonio
, Texas 78258-4349
(903) 877-5080
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Jeremy Lee Dickerson
- Po Box 847824
- Dallas, TX
- Zip : 75284-7824
- Fax : (903) 877-5080
- Phone : (903) 877-7777
Second Address
- Dr. Jeremy Lee Dickerson
- 1139 E Sonterra Blvd Ste 205
- San Antonio, TX
- Zip : 78258-4349
- Phone : (210) 874-3359
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | BP10035367 | TX |
| Y | 207QS0010X | Family Doctor - Sports Medicine | P4860 | TX |
National Provider Identifier
| NPI | 1043446206 |
|---|---|
| Provider Name | Dr. Jeremy Lee Dickerson |
| First Address | Dallas, TX 75284-7824 |
| Second Address | San Antonio, TX 78258-4349 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/06/2009 |
| Last Update Date | 27/11/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.