Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Dustin Clifton Derrick, MD

Individual provider Surgery Physician · NPI 1295049070

Dr. Dustin Clifton Derrick, MD is a Plastic and Reconstructive Surgery in Fort Worth, Texas. Graduated from University of Texas Medical School at San Antonio in 2010, 16 years ago. Practices with Texas Plastic Surgery Associates, PA, a 4-clinician group and accepts Medicare assignment. Licensed in Ohio and Texas.

Years since qualifying
16
Trained at
University of Texas Medical School at San Antonio
Licensed in
OH, TX
In the registry since
2010
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

800 12th Ave Ste 100
Fort Worth, TX 76104-2519
Phone: (817) 810-0770
Fax: (817) 820-0242
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X · Licence Q4085 (TX)
Surgery Physician Taxonomy 208600000X · Licence Q4085 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 57. 025880 (OH)

Record details

NPI number1295049070
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 3, 2010
Last updated in NPPESOctober 13, 2021
Certification dateOctober 13, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolUNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Graduated 2010 (16 years in practice)
Group practice Texas Plastic Surgery Associates, Pa — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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