Provider Demographics
NPI:1013594258
Name:BARNOLA, DEBORA E (APRN PNP-AC)
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:E
Last Name:BARNOLA
Suffix:
Gender:F
Credentials:APRN PNP-AC
Other - Prefix:
Other - First Name:DEBORA
Other - Middle Name:E
Other - Last Name:BARNOLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PNP-AC
Mailing Address - Street 1:2307 MILL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2508
Mailing Address - Country:US
Mailing Address - Phone:832-656-0388
Mailing Address - Fax:
Practice Address - Street 1:18200 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1285
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018443363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX334123201Medicaid