MEDICARE: DEBORAH M WESTERGAARD MDPA

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	174400000X	Specialist	H3539	TX

General Provider Information

NPI Number	:	1083667554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH M WESTERGAARD MDPA

Provider Business Mailing Address
First Line	:	P.O. BOX 918005
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-8005
Country	:	US
Telephone Number	:	214-750-6200
Fax Number	:	214-750-6203

Provider Business Practice Location Address
First Line	:	9301 N. CENTRAL EXPRESSWAY
Second Line	:	SUITE 115
City	:	DALLAS
State	:	TX
Zip	:	75231-0806
Country	:	US
Telephone Number	:	214-750-6200
Fax Number	:	214-750-6203

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	03/18/2013

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