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Individual

DR. DEREK C DIFFENDAFFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7600 W TIDWELL RD STE 103, HOUSTON, TX 77040-5719
(713) 461-3573
Mailing address
4502 E 41ST ST., SCHUSTERMAN CENTER, TULSA, OK 74135-2512
(918) 660-3000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R9206
TX
390200000X
Student in an Organized Health Care Education/Training Program
OK

Other

Enumeration date
05/01/2012
Last updated
12/21/2018
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