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NPI Code Detail

MEDICARE: LISTER DEBINYA

MEDICARE: LISTER DEBINYA
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1881267094
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISTER DEBINYA
Provider Business Mailing Address
First Line : 605 S CONROE MEDICAL DR
Second Line :
City : CONROE
State : TX
Zip : 77304-4722
Country : US
Telephone Number : 936-539-4004
Fax Number : 936-539-3635
Provider Business Practice Location Address
First Line : 605 S CONROE MEDICAL DR
Second Line :
City : CONROE
State : TX
Zip : 77304-4722
Country : US
Telephone Number : 936-539-4004
Fax Number : 936-521-3964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2021
Last Update Date : 05/04/2026

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Directions to “ LISTER DEBINYA ” Practice Location

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