Provider Demographics
NPI:1629074844
Name:KUHL, DEREK PETER (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:PETER
Last Name:KUHL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2601
Mailing Address - Country:US
Mailing Address - Phone:979-776-8330
Mailing Address - Fax:979-774-9157
Practice Address - Street 1:2806 E 29TH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2601
Practice Address - Country:US
Practice Address - Phone:979-776-8330
Practice Address - Fax:979-774-9157
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2390207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145848103Medicaid
TX145848103Medicaid
TX8C0535Medicare PIN