Provider Demographics
NPI:1053364927
Name:DOCKERY, WILLIAM DEE III (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DEE
Last Name:DOCKERY
Suffix:III
Gender:M
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:PO BOX 195096
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-8601
Mailing Address - Country:US
Mailing Address - Phone:469-856-0564
Mailing Address - Fax:
Practice Address - Street 1:5546 DRANE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-5506
Practice Address - Country:US
Practice Address - Phone:214-929-0819
Practice Address - Fax:214-594-0129
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK81222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118680105Medicaid
TX118680108Medicaid
TX118680106Medicaid
TX118680107Medicaid
TX160832504Medicaid
TXP00034764Medicare PIN
TX118680108Medicaid
G53905Medicare UPIN
TX8F6536Medicare PIN
TX8B2513Medicare PIN
TXP00011314Medicare PIN
TX160832504Medicaid
TX8009B9Medicare PIN