Provider Demographics
NPI:1598526451
Name:CHASE DERRICK MD PLLC
Entity type:Organization
Organization Name:CHASE DERRICK MD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:D
Authorized Official - Last Name:DERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-424-1300
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty