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NPI Code Detail

MEDICARE: DANIELLE DEBACKER

MEDICARE: DANIELLE DEBACKER
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
1183500000XPharmacist56670TX

General Provider Information

NPI Number : 1437535044
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE DEBACKER
Provider Business Mailing Address
First Line : 221 3RD ST W
Second Line :
City : UNIVERSAL CITY
State : TX
Zip : 78150-4800
Country : US
Telephone Number : 210-652-6403
Fax Number :
Provider Business Practice Location Address
First Line : 221 3RD ST W
Second Line :
City : UNIVERSAL CITY
State : TX
Zip : 78150-4800
Country : US
Telephone Number : 210-652-6403
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2015
Last Update Date : 08/07/2015

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Directions to “ DANIELLE DEBACKER ” Practice Location

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