Derek Anthony Nelson
Individual provider Active NPI Private Vehicle · Fairview, TX
NPI 1932057437 · NPPES record last updated Mar 19, 2026
Key facts
- NPI
- 1932057437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Private Vehicle 347C00000X
- License
- 12419996 (TX)
- Practice address
- 163 Town PL Ste 50
Fairview, TX 75069-1821 - Phone
- (800) 496-4060
- NPI assigned
- Mar 19, 2026
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12419996 | TX | MD | Private Vehicle |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | 12419996 | TX | Yes |
Addresses
Primary practice location
163 Town PL Ste 50
Fairview, TX 75069-1821
Mailing address
163 Town PL Ste 50
Fairview, TX 75069-1821
Phone (800) 496-4060
Other providers in Fairview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2026. 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.