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General NPI Number Information
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NPI Number | 1164607446
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Entity Type | Individual
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Provider Name | DERRICK WILLIAM DVORAK MD
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Gender | Male
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Dates
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Enumeration Date | 01/04/2008
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 6800 SCENIC DR
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City | ROWLETT
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State | TX
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Zip | 75088-4552
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Country | US
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Telephone | 972-520-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 4835 LBJ FWY STE 900
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City | DALLAS
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State | TX
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Zip | 75244-6001
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Country | US
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Telephone | 469-420-5527
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | P3527
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01068417A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 7526
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License Number State | SD
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