Provider Demographics
NPI:1609886910
Name:TIMBS, DEREK JASON (RN MSN FNP)
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:JASON
Last Name:TIMBS
Suffix:
Gender:M
Credentials:RN MSN FNP
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Mailing Address - Street 1:1731 W WHEELER AVE
Mailing Address - Street 2:
Mailing Address - City:ARANSAS PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78336-4536
Mailing Address - Country:US
Mailing Address - Phone:361-758-5326
Mailing Address - Fax:361-758-2137
Practice Address - Street 1:1731 W WHEELER AVE
Practice Address - Street 2:
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-4536
Practice Address - Country:US
Practice Address - Phone:361-643-4546
Practice Address - Fax:361-643-7986
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2008-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX669983207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX813753OtherBCBS
TX813753OtherBCBS