Individual
PAUL MICHAEL DEROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2805 E PRESIDENT GEORGE BUSH HWY, RICHARDSON, TX 75082-3561
(469) 204-6100
(469) 726-6141
Mailing address
2805 E PRESIDENT GEORGE BUSH HWY, RICHARDSON, TX 75082-3561
(469) 204-6100
(469) 726-6141
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
4301088486
MI
2085R0001X
Radiation Oncology Physician
Primary
N9842
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283831001
—
TX
05
—
283831003
—
TX
Enumeration date
06/01/2007
Last updated
10/28/2021
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