MEDICARE: DEBRA HUBBARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1043743164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA HUBBARD

Provider Business Mailing Address
First Line	:	12219 LEATHER SADDLE CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-2484
Country	:	US
Telephone Number	:	713-443-7641
Fax Number	:

Provider Business Practice Location Address
First Line	:	12219 LEATHER SADDLE CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-2484
Country	:	US
Telephone Number	:	713-443-7641
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	06/23/2017

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Directions to “ DEBRA HUBBARD ” Practice Location

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