1356717235 NPI number — MRS. DEBORAH DENSUA LARBIE FNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356717235 NPI number — MRS. DEBORAH DENSUA LARBIE FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LARBIE
Provider First Name:
DEBORAH
Provider Middle Name:
DENSUA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DODOO
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
DENSUA
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356717235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3129 INTERSTATE 30 STE H
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MESQUITE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75150-2788
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-979-7408
Provider Business Mailing Address Fax Number:
214-227-2410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3334 BROADWAY BLVD STE 422
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75043-1575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-979-7408
Provider Business Practice Location Address Fax Number:
972-587-6733
Provider Enumeration Date:
08/14/2015

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: 363LF0000X , with the licence number:  AP128811 , 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: AP128811 . This is a "APRN LICENSE NO" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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