JERRY W DODSON (NPI# 1932110806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932110806 |
| Entity Type | Individual |
| Full Name | JERRY W DODSON |
| Credential | M.D. |
| Practice Address |
417 Montecito Dr San Angelo TX 76903-7342 |
| Practice Telephone | 3256591787 |
| Practice Fax Number | 3256595501 |
| Mailing Telephone | 3256591787 |
| Mailing Fax Number | 3256595501 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
D8195 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TAX ID | 82-0368325 | 01 | |
| TX | 098697802 | 05 |
| Street Address |
417 MONTECITO DR |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76903-7342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902833981 | Robert Hadley Gross | Psychiatry & Neurology | 417 Montecito Dr, San Angelo, TX 76903-9103 | 2006-06-27 |
| 1427193630 | San Angelo Psychiatric Association, Pllc | Psychiatry & Neurology | 417 Montecito Dr, San Angelo, TX 76903-7342 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306386081 | The Waterford Wellness Spa | Clinic/Center | 602 S. Abe, San Angelo, TX 76903 | 2017-03-01 |
| 1154782415 | Jerrica Elayne Escobedo | Counselor | 424 South Oakes, San Angelo, TX 76903 | 2016-03-15 |
| 1578923868 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3440 S. Bryant Blvd, San Angelo, TX 76903 | 2016-02-29 |
| 1821475161 | San Angelo Dental, Pllc | Dentist | 614 29th Street, Suite, Sanangelo, TX 76903 | 2015-05-06 |
| 1033549670 | Tina Faye Luck | Nurse Practitioner | 36 E Twohig Ave Ste 1100, San Angelo, TX 76903 | 2013-11-18 |
| 1295087294 | Tara Joiner | Counselor | 27 W Beauregard Ave, San Angelo, TX 76903 | 2012-10-15 |
| 1225380728 | Tanya L Favor | Physician Assistant | 215 E. College, San Angelo, TX 76903 | 2012-10-08 |
| 1336459551 | Education Service Center | Social Worker | 612 S Irene, San Angelo, TX 76903 | 2010-10-21 |
| 1508194176 | Pay and Save Inc | Pharmacy | 1926 N. Bryant Blvd., San Angelo, TX 76903 | 2009-11-19 |
| 1326375734 | Pay and Save Inc | Pharmacy | 2 S. Main St., San Angelo, TX 76903 | 2009-11-05 |
| Find all providers in zip 76903 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427193630 | San Angelo Psychiatric Association, Pllc | Psychiatry & Neurology | 417 Montecito Dr, San Angelo, TX 76903-7342 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861090243 | Ridgewood Psychiatry Pllc | Psychiatry & Neurology | 832 Ridgewood St, Brownsville, TX 78520 | 2020-10-16 |
| 1013525591 | El Paso Healthyminds Psychiatry, Pllc | Psychiatry & Neurology | 509 Rosinante Rd, El Paso, TX 79922-2224 | 2020-07-21 |
| 1073131686 | Nishan D. Adihetty Md, Pllc | Psychiatry & Neurology | 2219 Sawdust Rd Ste 1004, Spring, TX 77380-2580 | 2020-07-09 |
| 1063039535 | Sun Psychiatry Pllc | Psychiatry & Neurology | 12217 Sitting Bull Dr, El Paso, TX 79936-7891 | 2020-07-01 |
| 1942839113 | Fort Physicians & Professionals Pllc | Psychiatry & Neurology | 7140 Oakmont Boulevard, Fort Worth, TX 76132 | 2020-04-08 |
| 1720613532 | Ferruzzi Psychiatric Services, Pllc | Psychiatry & Neurology | 13409 Nw Military Hwy Ste 310, Shavano Park, TX 78231-1865 | 2020-03-12 |
| 1184276818 | Cesar Alejandro Soutullo Esperon | Psychiatry & Neurology | Ut Health, Department of Psychiatry, 1941 East Road, Houston, TX 77054-6010 | 2019-07-12 |
| 1881255594 | Aditya Sharma, Pllc | Psychiatry & Neurology | 4510 Medical Center Dr Ste 208, Mckinney, TX 75069-1602 | 2019-06-24 |
| 1154851590 | Stat Md Pllc | Psychiatry & Neurology | 2710 Sunset Strip Ste C, Greenville, TX 75402-3848 | 2017-06-18 |
| 1336693043 | Cognitive Psychiatry Pa | Psychiatry & Neurology | 1029 Highway 6 N, Ste 650-181, Houston, TX 77079-1043 | 2016-08-10 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANGELO |
| Zip Code | 76903 |
Please comment or provide details below to improve the information on JERRY W DODSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.