Provider Demographics
NPI:1518250844
Name:JOHN P. DICE, M.D., PA
Entity Type:Organization
Organization Name:JOHN P. DICE, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-259-4470
Mailing Address - Street 1:800 W 34TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1143
Mailing Address - Country:US
Mailing Address - Phone:512-454-5821
Mailing Address - Fax:512-459-9137
Practice Address - Street 1:800 W 34TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1143
Practice Address - Country:US
Practice Address - Phone:512-454-5821
Practice Address - Fax:512-459-9137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6031207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9464729OtherAETNA
TX8CV409OtherBLUE CROSS/BLUE SHIELD
TX0468234OtherCIGNA