Individual
ANGELINE DERHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5717 BALCONES DR, AUSTIN, TX 78731-4203
(512) 327-7000
(512) 314-1661
Mailing address
5717 BALCONES DR, AUSTIN, TX 78731-4203
(512) 314-1613
(512) 314-1661
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
S4460
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2016
Last updated
01/03/2024
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