Derderian, Raymond
Derderian, Raymond is an sole proprietor health care provider with primary practice located at 2965 Harrison St Ste 317, Beaumont TX 77702-1150. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Derderian, Raymond can be contacted via phone (409) 554-0911.Contact Information
Primary practice address
2965 Harrison St Ste 317
Beaumont TX 77702-1150
Phone: (409) 554-0911
Fax: (409) 554-0912
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | H0043 | Texas |
Profile Details
| NPI number | 1699779090 |
|---|---|
| LBN Legal business name | Derderian, Raymond |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 13th, 2005 |
| Last updated | Aug 18th, 2016 - about 9 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 | 1699779090 | NPPES |
| Texas | MEDICAID | 113566701 |
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