Provider Demographics
NPI:1013977107
Name:DALEHITE, JESSE JAY III (MD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:JAY
Last Name:DALEHITE
Suffix:III
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:JESS
Other - Middle Name:J
Other - Last Name:DALEHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1512
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-1512
Mailing Address - Country:US
Mailing Address - Phone:800-550-5606
Mailing Address - Fax:985-646-0750
Practice Address - Street 1:400 ROSALIND REDFERN GROVER PKWY
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5846
Practice Address - Country:US
Practice Address - Phone:432-221-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG32662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129298909Medicaid
TX129298909Medicaid
TX8C7096Medicare ID - Type Unspecified
TXC14984Medicare UPIN