Individual
DR. DEREK TEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5115 W BASELINE RD, LAVEEN, AZ 85339-3000
(602) 283-1603
Mailing address
5151 N 16TH ST APT 4038, PHOENIX, AZ 85016-3817
(562) 685-1927
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S024816
AZ
Other
Enumeration date
01/13/2021
Last updated
01/20/2021
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