Provider Demographics
NPI:1003927930
Name:DERBES, CHRISTOPHER JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:DERBES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 E VILLA MARIA RD
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2547
Mailing Address - Country:US
Mailing Address - Phone:979-776-4600
Mailing Address - Fax:979-774-0877
Practice Address - Street 1:2206 E VILLA MARIA RD
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2547
Practice Address - Country:US
Practice Address - Phone:979-776-4600
Practice Address - Fax:979-774-0877
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8514207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042357601Medicaid
H13923Medicare UPIN