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Active NPI 1982729216 Individual Practitioner Male Practitioner

Dallas Diederich , PA-C

Physician Assistant • Flint, TX

Professional Overview & Biography Verified Profile Summary

Dallas Diederich, PA-C is a registered healthcare professional specializing in Physician Assistant in Flint, TX. Practice services are available at 20208 STATE HIGHWAY 155 S under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

20208 State Highway 155 S

Flint, TX 757625600

Telephone 9038256222
Associated Practice Facility / Clinic
🏢 Trinity Clinic Facility NPI 1528297983

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Flint, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.0 Yrs
State Avg: 13.9 Yrs
Regional Practice Density
2 Specialists

Practicing in Flint, TX (11140 Statewide)

Telehealth Adoption Rate
50.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License TX PA00509

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
202460603 (TX)
Medicaid State Provider ID
202460602 (TX)
Medicaid State Provider ID
202460601 (TX)
Medicaid State Provider ID
202460604 (TX)
Commercial Insurance / Payer ID Tricare
75-0818167-044 (TX)
Commercial Insurance / Payer ID Tricare
75-0818167-015 (TX)
Commercial Insurance / Payer ID Tricare
752616977001 (TX)
Commercial Insurance / Payer ID Bcbs
8689NN (TX)
Commercial Insurance / Payer ID Rail Road Medicare
P01478958 (TX)
Commercial Insurance / Payer ID Tricare
752616977028 (TX)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Cheryl Henderson , FNP

Nurse Practitioner - Family

NPI 1043201304

Family Nurse Practitioner

Amy Delleney , PA

Physician Assistant

NPI 1356465421

Physician Assistant

Dr. Lisa Allen , DO

Family Medicine

NPI 1548225261

Doctor of Osteopathic Medicine (D.O.)

NPI 1609138486

Doctor of Osteopathic Medicine (D.O.)

Dr. Alan Eli , MD

Family Medicine

NPI 1700850393

Doctor of Medicine (M.D.)

Ronald Gilbert , NP-C

Nurse Practitioner

NPI 1780345553

Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 07, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location August 07, 2015

Registered at 20208 STATE HIGHWAY 155 S, FLINT, TX 757625600 (Tel: 9038256222)

📍
Updated Business Mailing Address August 07, 2015

Registered at PO BOX 846098, DALLAS, TX 752846098 (Tel: 9033246400)

👤
Provider Name / Credentials Updated August 07, 2015

Recorded as DALLAS DIEDERICH, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 07, 2015

Physician Assistant (License #PA00509 in TX)

🟢
Initial NPI Registration & Enumeration March 19, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982729216
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 19, 2007
Last Update: August 07, 2015
Sole Proprietor: Yes

Mailing Address

Po Box 846098

Dallas, TX 752846098

Phone: 9033246400

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.