Healthcare Provider Details

I. General information

NPI: 1679299697
Provider Name (Legal Business Name): DEBANY JOHANA MALPICA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4722 RIVERSTONE BLVD STE 100
MISSOURI CITY TX
77459-4723
US

IV. Provider business mailing address

630 COLONY LAKE ESTATES DR APT 937
STAFFORD TX
77477-4675
US

V. Phone/Fax

Practice location:
  • Phone: 346-368-4412
  • Fax:
Mailing address:
  • Phone: 346-290-6615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: