Individual provider · Type 1 NPI
Kenneth Willie Dickerson Sr.
Driver · Houston, TX
NPI number
1043744790
Active
Practice location
15530 Ella Blvd Apt 719
Houston, TX 77090
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | 24512126 (TX) |
| Prevention Professional | 405300000X | 24512126 (TX) |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
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About NPI 1043744790
Kenneth Willie Dickerson Sr.'s National Provider Identifier is 1043744790, issued on Apr 19, 2017. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Houston, TX. The record was last updated on Apr 19, 2017.