Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301094368 | MI |
N | 208600000X | Surgeon | 4301094368 | MI |
Y | 208200000X | Surgeon | Q9487 | TX |
Y | 208600000X | Surgeon | Q9487 | TX |
N | 2082S0105X | Plastic Hand Surgeon | Q9487 | TX |
NPI | 1376704346 |
---|---|
Provider Name | Dr. Derek Alexandre Rapp |
First Address | Richardson, TX 75082-3566 |
Second Address | Richardson, TX 75082-3566 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2008 |
Last Update Date | 03/08/2016 |