| Dallas Diederich, PA-C | |
|
20208 State Highway 155 S, Flint, TX 75762-5600 | |
| (903) 825-6222 | |
| Not Available |
| Full Name | Dallas Diederich |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 20208 State Highway 155 S, Flint, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982729216 | NPI | - | NPPES |
| 202460603 | Medicaid | TX | |
| 75-0818167-048 | Other | TX | TRICARE |
| 75-1976930-005 | Other | TX | TRICARE |
| 202460602 | Medicaid | TX | |
| 75-0818167-044 | Other | TX | TRICARE |
| 75-0818167-015 | Other | TX | TRICARE |
| 752616977001 | Other | TX | TRICARE |
| 8689NN | Other | TX | BCBS |
| P01478958 | Other | TX | RAIL ROAD MEDICARE |
| 202460601 | Medicaid | TX | |
| 752616977002 | Other | TX | TRICARE |
| 8EW436 | Other | TX | BCBS |
| P01478957 | Other | TX | RAIL ROAD MEDICARE |
| 75-2616977-001 | Other | TRICARE | |
| 8N3412 | Other | TX | BCBS |
| 202460604 | Medicaid | TX | |
| 75-0818167-022 | Other | TX | TRICARE |
| 752616977028 | Other | TX | TRICARE |
| 8679NN | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA00509 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Diederich, PA-C Po Box 846098, Dallas, TX 75284-6098 Ph: (903) 324-6400 | Dallas Diederich, PA-C 20208 State Highway 155 S, Flint, TX 75762-5600 Ph: (903) 825-6222 |
Amy L Delleney, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 20208 State Highway 155 S, Flint, TX 75762 Phone: 903-825-6222 | |
Ronnie Dale Nash, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 20208 State Highway 155 S, Flint, TX 75762 Phone: 903-825-6222 |