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NPI Code Detail

MEDICARE: DR. DARRYLL G DEVERA

MEDICARE: DR. DARRYLL G DEVERA
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
11223G0001XGeneral Practice Dentistry22340TX

General Provider Information

NPI Number : 1972776409
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARRYLL G DEVERA
Provider Business Mailing Address
First Line : 9567 S GESSNER DR
Second Line :
City : HOUSTON
State : TX
Zip : 77074-3813
Country : US
Telephone Number : 713-981-0025
Fax Number : 713-981-1660
Provider Business Practice Location Address
First Line : 9567 S GESSNER DR
Second Line :
City : HOUSTON
State : TX
Zip : 77074-3813
Country : US
Telephone Number : 713-981-0025
Fax Number : 713-981-1660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2008
Last Update Date : 04/04/2008

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Directions to “ DR. DARRYLL G DEVERA ” Practice Location

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