Maynard C Dyson
Pediatric Pulmonologist
1500 Cooper St
Fort Worth
, Texas 76104-2710
Maynard C Dyson
Pediatric Pulmonologist
1500 Cooper St
Fort Worth
, Texas 76104-2710
(682) 885-7347
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About
Features
Specialties
- Pediatric Pulmonologist
Languages spoken
- English
Location
First Address
- Maynard C Dyson
- Po Box 99371
- Fort Worth, TX
- Zip : 76199-0371
- Fax : (682) 885-7347
- Phone : (682) 885-1855
Second Address
- Maynard C Dyson
- 1500 Cooper St
- Fort Worth, TX
- Zip : 76104-2710
- Fax : (682) 885-1090
- Phone : (682) 885-6299
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0214X | Pediatric Pulmonologist | H9069 | TX |
National Provider Identifier
| NPI | 1619988763 |
|---|---|
| Provider Name | Maynard C Dyson |
| First Address | Fort Worth, TX 76199-0371 |
| Second Address | Fort Worth, TX 76104-2710 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/08/2006 |
| Last Update Date | 03/04/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00U87Z | BCBSTX GRP PIN (01) | TX |
| 10028696 | AMERIGROUP PIN (01) | TX |
| 109539 | SUPERIOR PIN (01) | TX |
| 112070100 | FIRSTCARE PIN (01) | TX |
| 136186712 | (05) | TX |
| 136186713 | CSHCN (01) | TX |
| 136186714 | (05) | TX |
| 136186715 | CSHCN (01) | TX |
| 1392667 | UHC PIN (01) | TX |
| 140442845 | (05) | TX |
| 1485631 | CIGNA PIN (01) | TX |
| 1640370 | FIRSTHEALTH PIN (01) | TX |
| 386710 | GREAT WEST PIN (01) | TX |
| 413449 | PHCS PIN (01) | TX |
| 4613484 | AETNA PIN (01) | TX |
| 62741133 | MULTIPLAN PIN (01) | TX |
| 89V243 | BCBSTX IND PIN (01) | TX |
| B60924 | (02) |
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.