Provider Demographics
NPI:1861997264
Name:N. DIKE D.O PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:N. DIKE D.O PROFESSIONAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NNAMDI
Authorized Official - Middle Name:CHIMA
Authorized Official - Last Name:DIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-407-8580
Mailing Address - Street 1:4323 N JOSEY LN STE 301
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4630
Mailing Address - Country:US
Mailing Address - Phone:214-407-8580
Mailing Address - Fax:214-407-8581
Practice Address - Street 1:4323 N JOSEY LN STE 301
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4630
Practice Address - Country:US
Practice Address - Phone:214-407-8580
Practice Address - Fax:214-407-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ51762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty