Individual
RYAN DERRAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(503) 539-6893
Mailing address
5412 SOUTHERN CROSSING DR, TEMPLE, TX 76502-7703
(503) 539-6893
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
31328
NE
Other
Enumeration date
08/05/2015
Last updated
08/19/2020
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