Individual
ERIC DERK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2826 ELSIE FAYE HEGGINS ST, DALLAS, TX 75215-4727
(972) 749-2668
Mailing address
308 HILLTOP DR, KENNEDALE, TX 76060-2616
(575) 640-5820
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4730
TX
Other
Enumeration date
07/27/2024
Last updated
07/27/2024
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