Healthcare Provider Details

I. General information

NPI: 1205509759
Provider Name (Legal Business Name): TONI DEER PA & COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 07/30/2021
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 COUNTY ROAD 405
MERKEL TX
79536-4138
US

IV. Provider business mailing address

598 COUNTY ROAD 405
MERKEL TX
79536-4138
US

V. Phone/Fax

Practice location:
  • Phone: 833-782-8277
  • Fax:
Mailing address:
  • Phone: 833-782-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: TONI L DEER
Title or Position: OWNER/MANAGER
Credential: PA
Phone: 833-782-8277