1760430219 NPI number — DR. CHRISTINA G DEUBER MD

Table of content: DR. CHRISTINA G DEUBER MD (NPI 1760430219)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760430219 NPI number — DR. CHRISTINA G DEUBER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEUBER
Provider First Name:
CHRISTINA
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760430219
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5470 W. LOVERS LANE STE 330
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-956-7337
Provider Business Mailing Address Fax Number:
469-364-8724

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5470 W. LOVERS LANE STE 330
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-956-7337
Provider Business Practice Location Address Fax Number:
469-364-8724
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  K0713 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 050622563 TIN PLLC . This is a "WESTCHESTER PEDIATRICS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 752660211 . This is a "TAXPAYOR NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: K0713 . This is a "MEDICL LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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