Provider Demographics
NPI:1528508025
Name:DEASON, DERICK D (FNP-C)
Entity type:Individual
Prefix:MR
First Name:DERICK
Middle Name:D
Last Name:DEASON
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 E. F. LOWRY EXPY #B
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-2279
Mailing Address - Country:US
Mailing Address - Phone:281-559-1122
Mailing Address - Fax:281-559-1188
Practice Address - Street 1:8901 E. F. LOWRY EXPY #B
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2279
Practice Address - Country:US
Practice Address - Phone:281-559-1122
Practice Address - Fax:281-559-1188
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily