DEREK JAMES PELLETIER (NPI# 1730105230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730105230 |
| Entity Type | Individual |
| Full Name | DEREK JAMES PELLETIER |
| Credential | PAC |
| Practice Address |
2504 Ridge Road Suite 203 Rockwall TX 75087 |
| Mailing Address |
1553 Hwy 34 South #600 Terrell TX 75160 |
| Practice Telephone | 2147713100 |
| Practice Fax Number | 2147713101 |
| Mailing Telephone | 9725638500 |
| Mailing Fax Number | 9725638501 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA03964 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2504 RIDGE ROAD SUITE 203 |
| City | ROCKWALL |
| State | TX |
| Zip Code | 75087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093704686 | Thomas Stephen Sudela | Obstetrics & Gynecology | 2504 Ridge Road, Suite 201, Rockwall, TX 75087 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104452309 | Schweers Dental Pllc | Clinic/Center | 3005 N Goliad St., Suite 110, Rockwall, TX 75087 | 2020-03-19 |
| 1467091611 | Elsa Varughese | Nurse Practitioner | 414 Garrett Dr, Rockwall, TX 75087 | 2020-01-04 |
| 1578105391 | Jaya Raji Mathai | Psychiatry & Neurology | 2249 Ridge Rd., Rockwall, TX 75087 | 2019-10-14 |
| 1104326784 | Eunice B Ontita | Nurse Practitioner | 601 White Hills Dr., Suite 100, Rockwall, TX 75087 | 2018-02-20 |
| 1053811885 | Emelda Fehnyui Ndinjiakat | Licensed Vocational Nurse | 610 Louder Way, Fate, TEXAS 75087 | 2018-02-19 |
| 1588163885 | January Lauren Green | Nurse Practitioner | 6800 Heritage Parkway, Suite 201, Rockwall, TX 75087 | 2018-02-02 |
| 1093268328 | Anouk Family Chiropractic, Pllc | Chiropractor | 2555 Ridge Rd #150, Rockwall, TX 75087 | 2016-08-03 |
| 1962858134 | Katherine L. Crane | Counselor | 302 W. Kaufman St., Rockwall, TX 75087 | 2016-05-06 |
| 1669841102 | Richard Carroll Smith | Obstetrics & Gynecology | 2120 Clubview, Rockwall, TX 75087 | 2015-09-15 |
| 1033598032 | Michelle Knight | Massage Therapist | 767 Justin Rd, Rockwall, TX 75087 | 2015-05-22 |
| Find all providers in zip 75087 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093281180 | Tammy Nguyen | Physician Assistant | 3164 Horizon Rd # 100, Rockwall, TX 75032-7805 | 2018-10-16 |
| 1780196717 | Arze Medical Pllc | Physician Assistant | 3864 Juniper Hills Dr, Rockwall, TX 75032-9233 | 2017-10-31 |
| 1346670056 | Mark Hill Hokett | Physician Assistant | 3090 N Goliad St Ste 110, Rockwall, TX 75087 | 2013-11-15 |
| 1598026940 | Karen Melinda Bartosh | Physician Assistant | 1118 Newkirk Ct, Rockwall, TX 75032-7474 | 2012-06-01 |
| 1104130426 | Brenda Wallace | Physician Assistant | 3142 Horizon Rd Ste 209, Rockwall, TX 75032-7802 | 2010-07-28 |
| 1619280948 | Christina L Roberts | Physician Assistant | 1005 W Ralph Hall Pkwy Ste 201, Rockwall, TX 75032-6662 | 2010-07-15 |
| 1043359920 | Randall Farrer | Physician Assistant | 3142 Horizon Rd Ste 100, Rockwall, TX 75032-7815 | 2007-02-06 |
| 1760544811 | Richard Alfred Labelle | Physician Assistant | 3912 Whitman Dr, Rockwall, TX 75087-6592 | 2006-12-15 |
| 1851313340 | Hayward Johnson Sr. | Physician Assistant | 810 E Ralph Hall Pkwy, Suite 100, Rockwall, TX 75032-6878 | 2006-07-24 |
| 1114950359 | Loretta Fern Docekal | Physician Assistant | 3090 N. Goliad Suite 110, Rockwall, TX 75087 | 2006-07-09 |
| Find all providers in ROCKWALL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.