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Contact Information

DEREN R GREEN
1401 DEZARAE LOT #3
SAN ANTONIO, TX78253
 Phone: 210-875-1437
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for DEREN R GREEN · (Male)

NPI Number 1194374215
Status Active
Credentials
Entity Individual
Enumeration date 09/11/2019
Last updated 09/11/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • TX License # 12145
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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