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General NPI Number Information
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NPI Number | 1366425944
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Entity Type | Individual
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Provider Name | DALERIE A. WILKERSON DPM
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Gender | Female
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 303 E OVERTON RD BLUITT-FLOWERS HEALTH CENTER
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City | DALLAS
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State | TX
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Zip | 75216-5946
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Country | US
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Telephone | 214-266-4200
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Fax | 214-266-4218
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Provider Business Mailing Address
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Address Line | PO BOX 660599
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City | DALLAS
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State | TX
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Zip | 75266-0599
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Country | US
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Telephone |
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Fax |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 1527
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License Number State | TX
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