Provider Demographics
NPI:1720720717
Name:DICKEY, DEVON WEIDNER (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:WEIDNER
Last Name:DICKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 S FRYERS CREEK CIR APT 1107
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-7584
Mailing Address - Country:US
Mailing Address - Phone:214-502-5541
Mailing Address - Fax:
Practice Address - Street 1:6431 FANNIN ST RM 5.170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-7160
Practice Address - Fax:713-500-0648
Is Sole Proprietor?:No
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program