Individual
AVERI DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 SCOTT AND WHITE DR STE 3.600, COLLEGE STATION, TX 77845-6440
(979) 207-4380
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(800) 994-0371
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1341830
TX
Other
Enumeration date
02/22/2021
Last updated
12/07/2023
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