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COURTNEY KOWALCZYK DERDERIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1935 MEDICAL DISTRICT DR, DEPARTMENT OF ANESTHESIOLOGY, DALLAS, TX 75235-7701
(214) 456-6393
(214) 456-7232
Mailing address
1935 MEDICAL DISTRICT DR, DEPARTMENT OF ANESTHESIOLOGY, DALLAS, TX 75235-7701
(214) 456-6393
(214) 456-7232

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
P2708
TX
207LP3000X
Pediatric Anesthesiology Physician
P2708
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3054389 01
TX
Enumeration date
06/08/2007
Last updated
11/25/2015
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