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CHARLES H. DICKERSON
NPI 1578589503
Clinic/Center - Radiology, Mobile in Tyler, TX

Active since July 14, 2006
2208 OLD HENDERSON HWY, TYLER, TX 75702(903) 596-9729(903) 596-7206 Get Directions Write a Review

NPPES record last updated: June 30, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Charles H. Dickerson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES H. DICKERSON (NPI 1578589503) is a healthcare organization registered as a radiology, mobile in Tyler, Texas and active in the NPI registry since July 2006. The organization lists Charles H Dickerson, Owner, as its authorized official.

NPPES Registry Identity

NPI1578589503
Entity TypeOrganization
Primary Taxonomy261QR0208X
Legal Business NameCHARLES H. DICKERSON
Location Address2208 OLD HENDERSON HWYTyler, TX 75702-6457
Mailing AddressPo Box 9700Tyler, TX 75711-2700 · (903) 596-9729 · Fax (903) 596-7206
Phone(903) 596-9729
Fax(903) 596-7206
Organization SubpartNo
Authorized OfficialCharles H DickersonOwner · (903) 596-9729
Enumeration DateJuly 14, 2006
Last NPPES UpdateJune 30, 2014
✔ NPI 1578589503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Radiology, MobileAmbulatory Health Care Facilities
Taxonomy Code261QR0208X
License✔ Licensed in TX · 6309
2208 OLD HENDERSON HWY, Tyler, TX 75702
Open in Google Maps ↗

Other Identifiers 2

Medicaid0860918 01TX
Medicare PIN459845TX

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARLES H DICKERSON
Radiologic Technologist
2208 OLD HENDERSON HWY
TYLER, TX 75702
Smith County (903) 596-9729

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles H. Dickerson's NPI number?

The NPI number for Charles H. Dickerson is 1578589503. It was assigned to this organization in the NPPES registry on July 14, 2006.

Where is Charles H. Dickerson located?

Charles H. Dickerson is located at 2208 Old Henderson Hwy, Tyler, TX 75702. The listed phone number is (903) 596-9729.

What is Charles H. Dickerson's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, Mobile, with taxonomy code 261QR0208X.

When was this NPI record last updated?

The NPPES record for Charles H. Dickerson was last updated on June 30, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.