Provider Demographics
NPI:1346434479
Name:WHITSELL, DENNIS DEE (RT)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:DEE
Last Name:WHITSELL
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 COUNTY ROAD 473
Mailing Address - Street 2:
Mailing Address - City:DE LEON
Mailing Address - State:TX
Mailing Address - Zip Code:76444-6221
Mailing Address - Country:US
Mailing Address - Phone:254-893-5181
Mailing Address - Fax:254-893-5181
Practice Address - Street 1:391 COUNTY ROAD 473
Practice Address - Street 2:
Practice Address - City:DE LEON
Practice Address - State:TX
Practice Address - Zip Code:76444-6221
Practice Address - Country:US
Practice Address - Phone:254-893-5181
Practice Address - Fax:254-893-5181
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR31570335V00000X
TX129812471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTUV12Medicare PIN