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NPI Code Detail

MEDICARE: DEBORAH GADDY

MEDICARE: DEBORAH GADDY
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
1164X00000XLicensed Vocational Nurse351521TX

General Provider Information

NPI Number : 1053128058
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH GADDY
Provider Business Mailing Address
First Line : PO BOX 33351
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78265-3351
Country : US
Telephone Number : 210-251-6793
Fax Number :
Provider Business Practice Location Address
First Line : 6938 WALZEM RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78239-3641
Country : US
Telephone Number : 210-969-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2024
Last Update Date : 12/15/2024

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Directions to “ DEBORAH GADDY ” Practice Location

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