Provider Demographics
NPI:1558469379
Name:ARNECKE, DARREN J (MD)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:J
Last Name:ARNECKE
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 1:115 MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-2138
Mailing Address - Country:US
Mailing Address - Phone:903-439-0205
Mailing Address - Fax:903-439-2990
Practice Address - Street 1:115 MEDICAL CIR
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2138
Practice Address - Country:US
Practice Address - Phone:903-439-0205
Practice Address - Fax:903-439-2990
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7300207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0027AGOtherBLUE CROSS BLUE SHIELD
TX029970301Medicaid
110128301OtherRAILROAD MEDICARE
110128301OtherRAILROAD MEDICARE
TX029970301Medicaid
TX0027AGMedicare PIN