MEDICARE: DR. DERRICK ASKINS D.D.S

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
1	1223G0001X	General Practice Dentistry	22040	TX

General Provider Information

NPI Number	:	1750449328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DERRICK ASKINS D.D.S

Provider Business Mailing Address
First Line	:	269 E OVILLA RD STE 300
Second Line	:
City	:	RED OAK
State	:	TX
Zip	:	75154-2616
Country	:	US
Telephone Number	:	972-576-0248
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 KNOX ST
Second Line	:	SUITE 300
City	:	DALLAS
State	:	TX
Zip	:	75205-5584
Country	:	US
Telephone Number	:	214-265-7771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	09/20/2012

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