Healthcare Provider Details

I. General information

NPI: 1780063131
Provider Name (Legal Business Name): DEUBS HOME VISITS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 05/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2088 BRONCO LN
KELLER TX
76248-3139
US

IV. Provider business mailing address

2088 BRONCO LN
KELLER TX
76248-3139
US

V. Phone/Fax

Practice location:
  • Phone: 862-241-0099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. LANDRY P DEUBOUE
Title or Position: NURSE PRACTITIONER
Credential:
Phone: 862-241-0099