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1700615945
ERIC DERK
DALLAS, TX
NPI
1700615945
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX AT4730)
Enumeration Date
2024-07-27
Last Update Date
2024-07-27
Business Address
ERIC DERK
2826 ELSIE FAYE HEGGINS ST
DALLAS, TX 75215-4727
Phone number: 972-749-2668
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Mailing Address
ERIC DERK
308 HILLTOP DR
KENNEDALE, TX 76060-2616
Phone number: 575-640-5820
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