Dekerlegand, Dirk Andrew

Dekerlegand, Dirk Andrew is an individual health care provider with primary practice located at 4103 S Medford Dr , Lufkin TX 75901-5633. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Dekerlegand, Dirk Andrew can be contacted via phone (936) 639-2384.

Contact Information

Primary practice address
4103 S Medford Dr Lufkin TX 75901-5633
Phone: (936) 639-2384
Fax: (936) 639-9888
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA00642 Texas

Profile Details

NPI number 1679503965
LBN Legal business name Dekerlegand, Dirk Andrew
Credentials P.A.C.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Jul 30th, 2008 - about 17 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 1679503965 NPPES
Texas MEDICAID 181080601

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