Paul Edward Deroulet, LBSW, LCDC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

35018 Issued in TX

Practice address

303 Jackson Hill St
Houston, TX 77007-7407

Phone

(713) 942-4100

Fax

(713) 400-3549

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750590576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 MEMORIAL DR APT 38",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770244814",
            "telephone_number": "713-973-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 JACKSON HILL ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770077407",
            "telephone_number": "713-942-4100",
            "fax_number": "713-400-3549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROULET",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LBSW, LCDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "35018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermatology Management Services PLLC (Team Dermatology)
• Dermatology of the Southwest PA
• Dermpreneur, PLLC
• Daniel Dernick, D.D.S.
• Deross Provider Services Inc
• Heather M Derousse, LCSW
• Jason Michael Derr, DDS
• Kadria N Derrick, MD
• Katherine K. Derry, LPC
• Michelle L Derusso, M.D.

• Case Manager/Care Coordinator in Houston, TX
• Providers in Houston, TX by specialty
• Case Manager/Care Coordinator in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.