Organization Active NPI

Mark E Dickson MD PA

  • Surgery Physician
  • Sherman, TX
National Provider Identifier
1366548414
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MARK E DICKSON MD PA
Practice address
3305 N Calais St
Suite #100
Sherman, TX 75090-3110
Phone
(903) 957-0016
Fax
(903) 957-0038
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Dr. Mark Edward Dickson, MD
Title
President
Phone
(903) 957-0016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3305 N Calais St
Suite #100
Sherman, TX 75090-3110

Mailing address

3305 N Calais St
Suite #100
Sherman, TX 75090-3110
Phone (903) 957-0016

Other identifiers 1

IdentifierTypeStateIssuer
200078600AMedicaidOK

National Provider Directory

National Provider Directory

Locations

1901 W University Blvd
Durant, OK 74701
Phone (580) 920-2020

1014 Memorial Dr
Ste 208
Denison, TX 75020
Phone (903) 416-6240

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1366548414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 N CALAIS ST",
            "address_2": "SUITE #100",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750903110",
            "telephone_number": "903-957-0016",
            "fax_number": "903-957-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 N CALAIS ST",
            "address_2": "SUITE #100",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750903110",
            "telephone_number": "903-957-0016",
            "fax_number": "903-957-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK E DICKSON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-957-0016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200078600A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.