Provider Demographics
NPI:1003399965
Name:VARNER, DEBORAH SUE
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUE
Last Name:VARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 ALABAMA AVE
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2615
Mailing Address - Country:US
Mailing Address - Phone:281-332-9588
Mailing Address - Fax:
Practice Address - Street 1:411 ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2615
Practice Address - Country:US
Practice Address - Phone:281-724-2502
Practice Address - Fax:281-724-2502
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2016903225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant