Provider Demographics
NPI:1447823257
Name:REAM, DEREK (PSYD, MS)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:
Last Name:REAM
Suffix:
Gender:
Credentials:PSYD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SUMMER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6921
Mailing Address - Country:US
Mailing Address - Phone:812-402-9227
Mailing Address - Fax:
Practice Address - Street 1:1510 SUMMER FOREST DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-6921
Practice Address - Country:US
Practice Address - Phone:812-402-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08251103TC0700X
TX39590103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical