Provider Demographics
NPI:1992914287
Name:DEREK K MAXSON
Entity type:Organization
Organization Name:DEREK K MAXSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:MAXSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-328-0303
Mailing Address - Street 1:9907 HIGHWAY 6 SOUTH
Mailing Address - Street 2:SUITE 360
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4995
Mailing Address - Country:US
Mailing Address - Phone:832-328-0303
Mailing Address - Fax:832-328-0404
Practice Address - Street 1:9907 HIGHWAY 6 SOUTH
Practice Address - Street 2:SUITE 360
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4995
Practice Address - Country:US
Practice Address - Phone:832-328-0303
Practice Address - Fax:832-328-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty