Individual provider Active NPI

Bryan Arnold Dickson, MD

  • Pediatric Endocrinology Physician
  • Dallas, TX
National Provider Identifier
1104887306
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
G8080 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone
(214) 730-5437
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 2024040558 MO
Pediatric Endocrinology Physician 2080P0205X G8080 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 730-5437

Other practice location 1

1965 S Fremont Ave Ste 220
Springfield, MO 65804-2283
Phone (417) 820-0280

Other identifiers 1

IdentifierTypeStateIssuer
128126303MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050304000212 TX Practitioner - Pediatric MedicinePractitioner - Endocrinology 1951355775 Reassigns benefits to 3 organizations
I20241112001528 MO Practitioner - Pediatric Medicine 1951355775 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G8080TXMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Nov 6, 2024 Accepting new patients
Baylor College of Medicine CurrentSince Feb 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Texas Children'S Physician Group CurrentSince Oct 12, 2021 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 4, 2010 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 6, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 6, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Aug 4, 2010 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Physicians Referral Service PastSince Oct 12, 2021 Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1965 S Fremont Ave
Ste 220
Springfield, MO 65804
Phone (417) 820-0280

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1104887306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-730-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-730-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1965 S Fremont Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042283",
            "country_code": "US",
            "telephone_number": "417-820-0280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "BRYAN",
        "middle_name": "ARNOLD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MO",
            "license": "2024040558",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "TX",
            "license": "G8080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128126303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.