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NPI Code Detail

MEDICARE: DEREK CHARLES BARTLETT

MEDICARE: DEREK CHARLES BARTLETT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist40543TX

General Provider Information

NPI Number : 1023502010
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK CHARLES BARTLETT
Provider Business Mailing Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 801-373-4760
Fax Number : 801-373-0639
Provider Business Practice Location Address
First Line : 6201 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-5202
Country : US
Telephone Number : 214-645-5555
Fax Number : 801-373-0639
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2018
Last Update Date : 12/08/2025

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