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General NPI Number Information
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NPI Number | 1013977107
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Entity Type | Individual
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Provider Name | JESSE JAY DALEHITE III M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 400 ROSALIND REDFERN GROVER PKWY
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City | MIDLAND
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State | TX
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Zip | 79701-5846
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Country | US
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Telephone | 432-221-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1512
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City | LOWELL
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State | AR
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Zip | 72745-1512
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Country | US
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Telephone | 800-550-5606
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Fax | 985-646-0750
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G3266
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License Number State | TX
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