Provider Demographics
NPI:1427059500
Name:DICKE, KAREL ADRIAAN (MD PHD)
Entity type:Individual
Prefix:
First Name:KAREL
Middle Name:ADRIAAN
Last Name:DICKE
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 W RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2510
Mailing Address - Country:US
Mailing Address - Phone:817-261-4906
Mailing Address - Fax:817-543-4675
Practice Address - Street 1:906 W RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2510
Practice Address - Country:US
Practice Address - Phone:817-261-4906
Practice Address - Fax:817-543-4671
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7388207RH0003X
NE18083207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100460801Medicaid
TX100460805Medicaid
TX100460804Medicaid
TX10460806Medicaid
TX8L23518Medicare PIN
TX10460806Medicaid
TX8L23519Medicare PIN
TX84T511Medicare ID - Type UnspecifiedCMS
TX100460801Medicaid
TX8L23520Medicare PIN