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General NPI Number Information
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NPI Number | 1508872888
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Entity Type | Individual
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Provider Name | DEBORAH K. COUNTIE MD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 09/17/2015
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Provider Practice Location Address
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Address Line | 4515 SETON CENTER PKWY #220
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City | AUSTIN
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State | TX
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Zip | 78759-5784
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Country | US
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Telephone | 512-338-8388
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Fax | 512-406-6274
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Provider Business Mailing Address
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Address Line | 4515 SETON CENTER PKWY SUITE 215
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City | AUSTIN
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State | TX
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Zip | 78759-5290
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Country | US
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Telephone | 512-231-5507
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Fax | 512-406-6216
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J3056
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License Number State | TX
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