Healthcare Provider Details

I. General information

NPI: 1427465533
Provider Name (Legal Business Name): JOHN R DEBUS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5477 GLEN LAKES DR SUITE 150
DALLAS TX
75231-0946
US

IV. Provider business mailing address

5477 GLEN LAKES DR SUITE 150
DALLAS TX
75231-0946
US

V. Phone/Fax

Practice location:
  • Phone: 214-373-9300
  • Fax: 214-373-9303
Mailing address:
  • Phone: 214-373-9300
  • Fax: 214-373-9303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG8821
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberG8821
License Number StateTX

VIII. Authorized Official

Name: DR. JOHN R DEBUS
Title or Position: PRESIDENT
Credential: MD
Phone: 214-373-9300