NPI age
19 years
Enumerated 2007-03-19
● Active
Type 1 · Individual
Dallas Diederich, PA-C
Diederich is 1 of 2 physician assistant providers in Flint and 1 of 11022 in Texas.
Primary specialty
Physician Assistant
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-08-07
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 11022 active physician assistant providers in Texas.
NPI age
19 years
↑ 9 yr above median (10 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
23% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Practice location
20208 State Highway 155 S
Flint, TX 757625600
Mailing address
Po Box 846098
Dallas, TX 752846098
Specialties
-
Physician Assistant PrimaryA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 202460603 | |
| 01 (TX) | 75-0818167-048 | TRICARE |
| 01 (TX) | 75-1976930-005 | TRICARE |
| 05 (TX) | 202460602 | |
| 01 (TX) | 75-0818167-044 | TRICARE |
| 01 (TX) | 75-0818167-015 | TRICARE |
| 01 (TX) | 752616977001 | TRICARE |
| 01 (TX) | 8689NN | BCBS |
| 01 (TX) | P01478958 | RAIL ROAD MEDICARE |
| 05 (TX) | 202460601 | |
| 01 (TX) | 752616977002 | TRICARE |
| 01 (TX) | 8EW436 | BCBS |
| 01 (TX) | P01478957 | RAIL ROAD MEDICARE |
| 01 | 75-2616977-001 | TRICARE |
| 01 (TX) | 8N3412 | BCBS |
| 05 (TX) | 202460604 | |
| 01 (TX) | 75-0818167-022 | TRICARE |
| 01 (TX) | 752616977028 | TRICARE |
| 01 (TX) | 8679NN | BCBS |
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.