Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | L2916 | TX |
NPI | 1447336664 |
---|---|
Provider Name | Derek Anthony Haas |
First Address | Dallas, TX 75248-1983 |
Second Address | Irving, TX 75039-2743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 31/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H53285 | (02) |