Healthcare Provider Details

I. General information

NPI: 1760430219
Provider Name (Legal Business Name): CHRISTINA G DEUBER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5470 W. LOVERS LANE STE 330
DALLAS TX
75209
US

IV. Provider business mailing address

5470 W. LOVERS LANE STE 330
DALLAS TX
75209
US

V. Phone/Fax

Practice location:
  • Phone: 214-956-7337
  • Fax: 469-364-8724
Mailing address:
  • Phone: 214-956-7337
  • Fax: 469-364-8724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK0713
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: