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General NPI Number Information
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NPI Number | 1063305985
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Entity Type | Organization
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Legal Business Name | DEBRA'S CROWN
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 625 CIMARRON TRACE
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City | GRAND PRAIRIE
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State | TX
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Zip | 75051
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Country | US
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Telephone | 214-718-2528
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Fax |
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Provider Business Mailing Address
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Address Line | 539 W COMMERCE ST # 6571
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City | DALLAS
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State | TX
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Zip | 75208-1953
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Country | US
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Telephone | 214-718-2528
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | MS. JAMELA LOVE
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Credential |
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Telephone | 214-718-2528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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