| 3 Dimension Inc | |
|
910 Jamie Dr Grand Prairie TX 75052-2735 | |
| (800) 254-0710 | |
| (800) 254-7175 |
| Full Name | 3 Dimension Inc |
|---|---|
| Speciality | Social Worker |
| Location | 910 Jamie Dr, Grand Prairie, Texas |
| Authorized Official Name and Position | Donna S Nickerson (OWNER) |
| Authorized Official Contact | 8002540710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 3 Dimension Inc 910 Jamie Dr Grand Prairie TX 75052-2735 Ph: (800) 254-0710 | 3 Dimension Inc 910 Jamie Dr Grand Prairie TX 75052-2735 Ph: (800) 254-0710 |
| NPI Number | 1942608658 |
|---|---|
| Provider Enumeration Date | 12/11/2014 |
| Last Update Date | 12/11/2014 |
| Medicare PECOS PAC ID | 7214254119 |
|---|---|
| Medicare Enrollment ID | O20150401002124 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942608658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 36829 (Texas) | Primary |
| Provider Name | Donna S Nickerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215349311 PECOS PAC ID: 7416270871 Enrollment ID: I20141216002120 |
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