Heath Derby, PHARMD
Individual provider Active NPI Pharmacist · Watauga, TX
NPI 1194054346 · NPPES record last updated Dec 17, 2009
Key facts
- NPI
- 1194054346
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 45246 (TX)
- Practice address
- 8020 Denton Hwy
Watauga, TX 76148-2464 - Phone
- (817) 428-5376
- NPI assigned
- Dec 17, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45246 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 45246 | TX | Yes |
Addresses
Primary practice location
8020 Denton Hwy
Watauga, TX 76148-2464
Mailing address
8020 Denton Hwy
Watauga, TX 76148-2464
Phone (817) 428-5376
Other providers in Watauga, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.