Individual
PROF. RAYMOND DERDERIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2965 HARRISON ST, STE 317, BEAUMONT, TX 77702-1150
(409) 554-0911
(409) 554-0912
Mailing address
2965 HARRISON ST, STE 317, BEAUMONT, TX 77702-1150
(409) 554-0911
(409) 554-0912
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
H0043
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113566701
—
TX
Enumeration date
06/13/2005
Last updated
08/18/2016
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