Provider Demographics
NPI:1710349287
Name:ASTROCYTE MANAGEMENT, PLLC
Entity Type:Organization
Organization Name:ASTROCYTE MANAGEMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-238-0512
Mailing Address - Street 1:14983 BOAZ LN
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-4801
Mailing Address - Country:US
Mailing Address - Phone:972-786-6167
Mailing Address - Fax:
Practice Address - Street 1:5575 FRISCO SQUARE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3309
Practice Address - Country:US
Practice Address - Phone:972-591-5935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty