Individual
MR. THOMAS V DERKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6550 FANNIN ST, SM1001, HOUSTON, TX 77030-2717
(713) 441-0005
(713) 790-6617
Mailing address
6550 FANNIN ST, SM1001, HOUSTON, TX 77030-2717
(713) 441-0005
(713) 790-6617
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
731442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009000261R
HUMANA
—
01
—
1730133026
BLUE CROSS BLUE SHIELD
TX
05
—
214435401
—
TX
05
—
43983800
—
WI
Enumeration date
05/20/2006
Last updated
04/09/2014
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