Active NPI
Derek David
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Houston, TX
National Provider Identifier
1982203287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 55123
- Practice address
- 12620 Woodforest Blvd Ste 200
Houston, TX 77015-3568 - Phone
- (713) 451-8121
- NPI assigned
- Oct 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 55123 | TX | Primary |
Addresses
Primary practice location
12620 Woodforest Blvd Ste 200
Houston, TX 77015-3568
Mailing address
13342 Bay Place Dr
Beach City, TX 77523-8211
Phone (832) 692-8536
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55123 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1982203287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13342 BAY PLACE DR",
"city": "BEACH CITY",
"state": "TX",
"postal_code": "775238211",
"telephone_number": "832-692-8536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12620 WOODFOREST BLVD STE 200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770153568",
"telephone_number": "713-451-8121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVID",
"first_name": "DEREK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-19",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "55123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.