Individual
DERRICK THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11502 BIG MESA DR, SAN ANTONIO, TX 78245-2257
(210) 290-4560
Mailing address
11502 BIG MESA DR, SAN ANTONIO, TX 78245-2257
(210) 290-4560
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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