Provider Demographics
NPI:1609886910
Name:TIMBS, DEREK JASON (RN MSN FNP)
Entity type:Individual
Prefix:MR
First Name:DEREK
Middle Name:JASON
Last Name:TIMBS
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Gender:M
Credentials:RN MSN FNP
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Mailing Address - Street 1:13306 GREENWOOD LAKES LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-5484
Mailing Address - Country:US
Mailing Address - Phone:346-432-5404
Mailing Address - Fax:660-951-7793
Practice Address - Street 1:13306 GREENWOOD LAKES LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-5484
Practice Address - Country:US
Practice Address - Phone:346-432-5404
Practice Address - Fax:660-951-7793
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2024-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX669983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX813753OtherBCBS
TX112554401Medicaid