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NPI Code Detail

MEDICARE: DEREK TYLER CLAR DO

MEDICARE: DEREK TYLER CLAR DO
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
1208M00000XHospitalist Physician324494NY
2207R00000XInternal Medicine Physician324494NY

General Provider Information

NPI Number : 1841811718
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK TYLER CLAR DO
Provider Business Mailing Address
First Line : 18511 HIGHLANDER MEDICS ST
Second Line :
City : FORT BLISS
State : TX
Zip : 79906-5327
Country : US
Telephone Number : 915-742-0460
Fax Number :
Provider Business Practice Location Address
First Line : 18511 HIGHLANDER MEDICS STREET
Second Line : DOM, EAST CLINIC 4TH FL
City : FORT BLISS
State : TX
Zip : 79906-5327
Country : US
Telephone Number : 915-742-0460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2020
Last Update Date : 07/15/2025

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