Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | L7799 | TX |
Y | 207PP0204X | Pediatric Emergency Physician | L7799 | TX |
N | 2080P0204X | Pediatric Emergency Doctor | L7799 | TX |
NPI | 1043296122 |
---|---|
Provider Name | Dr. Derek R Linklater |
First Address | Belton, TX 76513-1307 |
Second Address | Fort Hood, TX 76544-5060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2005 |
Last Update Date | 30/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164764604 | (05) | TX |
164777801 | (05) | TX |
8C0840 | BCBS (01) | TX |
I04167 | (02) | TX |