Individual
DEREK STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
227 HOOT OWL LN N, LEANDER, TX 78641-1733
(512) 297-3126
Mailing address
227 HOOT OWL LN N, LEANDER, TX 78641-1733
(512) 297-3126
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5275
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT5275
LICENSED ATHLETIC TRAINER
TX
Enumeration date
08/31/2014
Last updated
08/31/2014
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