DALLAS DIEDERICH PA-C
NPI 1982729216
Physician Assistant in Flint, TX

Active since March 19, 2007
20208 STATE HIGHWAY 155 S, FLINT, TX 75762(903) 825-6222 Get Directions Write a Review

NPPES record last updated: August 7, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dallas Diederich Pa-c NPPES

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

DALLAS DIEDERICH PA-C (NPI 1982729216) is an individual physician assistant in Flint, Texas, licensed in Texas (PA00509) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1982729216
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDALLAS DIEDERICHCredential: PA-C
Location Address20208 STATE HIGHWAY 155 SFlint, TX 75762-5600
Mailing AddressPo Box 846098Dallas, TX 75284-6098 · (903) 324-6400
Sole ProprietorYes
Enumeration DateMarch 19, 2007
Last NPPES UpdateAugust 7, 2015
NPI 1982729216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in TX · PA00509
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
20208 STATE HIGHWAY 155 S, Flint, TX 75762

Other Identifiers 26

Other8679NNTX · Bcbs
Other75-0818167-048TX · Tricare
Medicare PIN407052YS6VTX
OtherP01478958TX · Rail Road Medicare
Other75-0818167-015TX · Tricare
Medicaid202460602TX
Medicaid202460601TX
Other8N3412TX · Bcbs
Other752616977028TX · Tricare
Medicaid202460603TX
OtherP01478957TX · Rail Road Medicare
Other752616977001TX · Tricare
Other75-0818167-044TX · Tricare
Medicare ID-Type Unspecified87N973TX
Medicare PIN407048YS6PTX
Other75-2616977-001Tricare
Other752616977002TX · Tricare
Other75-1976930-005TX · Tricare
Medicare OSCAR/certification970026921TX
Medicare PIN8L13503TX
Other75-0818167-022TX · Tricare
Medicare UPINS56148TX
Other8EW436TX · Bcbs
Other8689NNTX · Bcbs
Medicaid202460604TX
Medicare PIN407048YNSXTX

Other Providers at the Same Location NPPES 6

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

Nurse Practitioner (Family)
20208 STATE HIGHWAY 155 S
FLINT, TX 75762
Physician Assistant
20208 STATE HIGHWAY 155 S
FLINT, TX 75762
Clinic/Center (Multi-Specialty)
20208 STATE HIGHWAY 155 S
FLINT, TX 75762
Family Medicine
20208 STATE HIGHWAY 155 S
FLINT, TX 75762
Nurse Practitioner
20208 STATE HIGHWAY 155 S
FLINT, TX 75762
Physician Assistant (Medical)
20208 STATE HIGHWAY 155 S
FLINT, TX 75762

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 Dallas Diederich's NPI number?

The NPI number for Dallas Diederich is 1982729216. It was assigned to this individual provider in the NPPES registry on March 19, 2007.

Where is Dallas Diederich located?

Dallas Diederich practices at 20208 State Highway 155 S, Flint, TX 75762. The listed phone number is (903) 825-6222.

What is Dallas Diederich's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Dallas Diederich was last updated on August 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.