Individual provider Active NPI

Daniel Joseph Derouen, BSPTA

  • Physical Therapy Assistant
  • Fairfield, TX
National Provider Identifier
1457256273
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2188331 Issued in TX
Practice address
352 W US Highway 84
Fairfield, TX 75840-4908
Phone
(903) 389-7433
NPI assigned
Oct 12, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2188331 TX Primary

Addresses

Primary practice location

352 W US Highway 84
Fairfield, TX 75840-4908

Mailing address

352 W US Highway 84
Fairfield, TX 75840-4908
Phone (903) 389-7433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1457256273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 W US HIGHWAY 84",
            "city": "FAIRFIELD",
            "state": "TX",
            "postal_code": "758404908",
            "telephone_number": "903-389-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 W US HIGHWAY 84",
            "city": "FAIRFIELD",
            "state": "TX",
            "postal_code": "758404908",
            "telephone_number": "903-389-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROUEN",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "BSPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2188331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.