Dr Derek Adam Gaudry, DDS is a
Dentist - Endodontics based in Ft Sam Houston, Texas. Dr Derek Adam Gaudry is licensed to practice in South Dakota (license number D0521) and his current practice location is
2018 Army Blvd, Apt A, Usa Dentac, Ft Sam Houston, Texas. He can be reached at his office (for appointments etc.) via phone at
(210) 221-0826.
NPI number for Dr Derek Adam Gaudry is 1225002652 and his current mailing address is 2018 Army Blvd, Apt A, Usa Dentac, Ft Sam Houston, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1225002652.
Healthcare Provider's Profile
| Full Name | Dr Derek Adam Gaudry |
|---|
| Gender | Male |
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| Speciality | Dentist - Endodontics |
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| Location | 2018 Army Blvd, Apt A, Ft Sam Houston, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1225002652
- Provider Enumeration Date: 02/14/2006
- Last Update Date: 06/19/2014
Medical Identifiers
Medical identifiers for Dr Derek Adam Gaudry such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225002652 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 105 (South Dakota) | Secondary |
| 1223E0200X | Dentist - Endodontics | D0521 (South Dakota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Derek Adam Gaudry is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Derek Adam Gaudry, DDS
2018 Army Blvd, Apt A, Usa Dentac,
Ft Sam Houston, TX 78234
Ph: (210) 221-0826 | Dr Derek Adam Gaudry, DDS
2018 Army Blvd, Apt A, Usa Dentac,
Ft Sam Houston, TX 78234
Ph: (210) 221-0826 |
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