Healthcare Provider Details

I. General information

NPI: 1255449245
Provider Name (Legal Business Name): DARRIN ASHBROOKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 01/17/2021
Certification Date: 01/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MALL DR
TEXARKANA TX
75503-2560
US

IV. Provider business mailing address

2001 MALL DR
TEXARKANA TX
75503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 903-306-2126
  • Fax: 903-949-6039
Mailing address:
  • Phone: 903-306-2126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberN6147
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberE-4821
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberN6147
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberE-4821
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: