Derksen, Thomas V

Derksen, Thomas V is an individual health care provider with primary practice located at 6550 Fannin St Sm1001, Houston TX 77030-2717. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Derksen, Thomas V can be contacted via phone (713) 441-0005.

Contact Information

Primary practice address
6550 Fannin St Sm1001 Houston TX 77030-2717
Phone: (713) 441-0005
Fax: (713) 790-6617
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 731442 Texas

Profile Details

NPI number 1730133026
LBN Legal business name Derksen, Thomas V
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Apr 9th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730133026 NPPES
Texas Other 1730133026 BLUE CROSS BLUE SHIELD
Texas MEDICAID 43983800 BLUE CROSS BLUE SHIELD
Texas Other 009000261R BLUE CROSS BLUE SHIELD
Texas MEDICAID 214435401 BLUE CROSS BLUE SHIELD

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