Individual
DARALYNN DEARDORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2825 STADIUM DR, FORT WORTH, TX 76109-1377
(817) 257-7864
(817) 257-7320
Mailing address
PO BOX 298730, FORT WORTH, TX 76129-0001
(817) 257-7864
(817) 257-7320
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
K7715
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150535602
—
TX
01
—
8X7761
BCBS
TX
Enumeration date
04/05/2006
Last updated
10/30/2008
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