Healthcare Provider Details

I. General information

NPI: 1013254135
Provider Name (Legal Business Name): DESIREE DEE WEBBER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESIREE DEE DIEBOLD DPM

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 E REDD RD
EL PASO TX
79912-7275
US

IV. Provider business mailing address

820 E REDD RD BLDG B
EL PASO TX
79912-7275
US

V. Phone/Fax

Practice location:
  • Phone: 915-581-0712
  • Fax:
Mailing address:
  • Phone: 915-581-0712
  • Fax: 915-533-8680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberTX3005
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberTR-128
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberTX3005
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: