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DEREK JAMES PELLETIER PAC
NPI 1730105230
Physician Assistant in Rockwall, TX

Active since July 15, 2006
2504 RIDGE ROAD, SUITE 203, ROCKWALL, TX 75087(214) 771-3100(214) 771-3101 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Derek James Pelletier Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEREK JAMES PELLETIER PAC (NPI 1730105230) is an individual physician assistant in Rockwall, Texas, licensed in Texas (PA03964) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1730105230
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDEREK JAMES PELLETIERCredential: PAC
Location Address2504 RIDGE ROAD, SUITE 203Rockwall, TX 75087
Mailing Address1553 Hwy 34 South, #600Terrell, TX 75160 · (972) 563-8500 · Fax (972) 563-8501
Phone(214) 771-3100
Fax(214) 771-3101
Sole ProprietorNo
Enumeration DateJuly 15, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1730105230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA03964
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2504 RIDGE ROAD, Rockwall, TX 75087
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Other Identifiers 1

Medicare UPINQ28788

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. THOMAS STEPHEN SUDELA MD
Obstetrics & Gynecology
2504 RIDGE ROAD, SUITE 201
ROCKWALL, TX 75087
Rockwall County (972) 722-0404

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Pelletier's NPI number?

The NPI number for Derek Pelletier is 1730105230. It was assigned to this individual provider in the NPPES registry on July 15, 2006.

Where is Derek Pelletier located?

Derek Pelletier practices at 2504 Ridge Road Suite 203, Rockwall, TX 75087. The listed phone number is (214) 771-3100.

What is Derek Pelletier's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Derek Pelletier was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.