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General NPI Number Information
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NPI Number | 1588806749
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Entity Type | Individual
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Provider Name | MATTHEW DICKSON M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 02/16/2022
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Provider Practice Location Address
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Address Line | 3142 HORIZON RD STE 110
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City | ROCKWALL
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State | TX
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Zip | 75032-7810
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Country | US
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Telephone | 972-771-1171
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Fax | 972-771-1173
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Provider Business Mailing Address
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Address Line | 3142 HORIZON RD STE 110
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City | ROCKWALL
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State | TX
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Zip | 75032-7810
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Country | US
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Telephone | 972-771-1171
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Fax | 972-771-1173
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | P0197
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License Number State | TX
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