Provider Demographics
NPI:1407141526
Name:DERRICK, CHASE D (MD)
Entity type:Individual
Prefix:
First Name:CHASE
Middle Name:D
Last Name:DERRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3060 COMMUNICATIONS PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8492
Mailing Address - Country:US
Mailing Address - Phone:972-424-1300
Mailing Address - Fax:214-387-1212
Practice Address - Street 1:3060 COMMUNICATIONS PKWY STE 201
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8492
Practice Address - Country:US
Practice Address - Phone:972-424-1300
Practice Address - Fax:214-387-1212
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR0559208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery