Provider Demographics
NPI:1053494484
Name:HERMANN, DARRELL (MD)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:
Last Name:HERMANN
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 1:7000 W PLANO PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8466
Mailing Address - Country:US
Mailing Address - Phone:214-483-9300
Mailing Address - Fax:214-483-9301
Practice Address - Street 1:7000 W PLANO PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8466
Practice Address - Country:US
Practice Address - Phone:214-483-9300
Practice Address - Fax:214-483-9301
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG72292086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1325581-01Medicaid
TX82A503Medicare PIN
TXC16842Medicare UPIN