Blanton, Derrick K
Blanton, Derrick K is an sole proprietor health care provider with primary practice located at 13284 Bugatti Dr , Frisco TX 75034-0916. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Blanton, Derrick K can be contacted via phone (214) 551-7104.Contact Information
Primary practice address
13284 Bugatti Dr
Frisco TX 75034-0916
Phone: (214) 551-7104
Fax: (214) 615-6358
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 32512 | Texas |
Profile Details
| NPI number | 1194830133 |
|---|---|
| LBN Legal business name | Blanton, Derrick K |
| Credentials | PYSD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2006 |
| Last updated | Feb 22nd, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194830133 | NPPES |
| Texas | MEDICAID | 170206001 |
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