MEDICARE: DEBORAH A SHED-ROBINSON

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	101YA0400X	Addiction (Substance Use Disorder) Counselor		TX

General Provider Information

NPI Number	:	1447945381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH A SHED-ROBINSON

Provider Business Mailing Address
First Line	:	11103 SAGECREST LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-3905
Country	:	US
Telephone Number	:	832-891-8769
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 BROADWAY ST
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77551-4241
Country	:	US
Telephone Number	:	409-944-4520
Fax Number	:

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

Provider Enumeration Date	:	04/06/2023
Last Update Date	:	04/06/2023

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