Des Peres Physician Network, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DES PERES PHYSICIAN NETWORK, LLC

Practice address

1445 Ross Ave Ste 1400
Dallas, TX 75202-2703

Phone

(469) 893-2000

NPI assigned

Jul 24, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy Adams

Title

SVP Regional Operations, Tenet

Phone

(469) 893-2563

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1336662147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 ROSS AVE STE 1400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752022703",
            "telephone_number": "469-893-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 ROSS AVE STE 1400",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752022703",
            "telephone_number": "469-893-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DES PERES PHYSICIAN NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "SVP REGIONAL OPERATIONS, TENET",
        "authorized_official_telephone_number": "469-893-2563"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latasha Deshea Derrick-Feyisetan, LMSW
• Howard C. Derrick III, M.D.
• Donald Dean Derryberry Jr., O.D.
• Jeff Dersh, PH.D.
• Kailey Derting, LPC-A
• Aalaap Desai, MD
• Amit P Desai, M.D.
• Ayush Ashesh Desai
• Dipti Vanraj Desai, PA-C
• Gargee Desai, MA, LPC

• All providers in Dallas, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.