Jonathan Eric Wickiser
Pediatrician Pediatric Hematology-Oncologist
5323 Harry Hines Blvd
Dallas
, Texas 75390-7201
Jonathan Eric Wickiser
Pediatrician Pediatric Hematology-Oncologist
5323 Harry Hines Blvd
Dallas
, Texas 75390-7201
(214) 730-5437
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About
Features
Specialties
- Pediatrician
- Pediatric Hematology-Oncologist
Languages spoken
- English
Location
First Address
- Jonathan Eric Wickiser
- Po Box 845347
- Dallas, TX
- Zip : 75284-5347
- Phone : (214) 730-5437
Second Address
- Jonathan Eric Wickiser
- 5323 Harry Hines Blvd
- Dallas, TX
- Zip : 75390-7201
- Phone : (214) 730-5437
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | M4653 | TX |
| Y | 2080P0207X | Pediatric Hematology-Oncologist | M4653 | TX |
National Provider Identifier
| NPI | 1194740688 |
|---|---|
| Provider Name | Jonathan Eric Wickiser |
| First Address | Dallas, TX 75284-5347 |
| Second Address | Dallas, TX 75390-7201 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/07/2006 |
| Last Update Date | 24/04/2012 |
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.