Provider Demographics
NPI:1073827127
Name:JULIETTE A DEPUE DO PA
Entity Type:Organization
Organization Name:JULIETTE A DEPUE DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIETTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEPUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-266-7673
Mailing Address - Street 1:2405 S GESSNER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2000
Mailing Address - Country:US
Mailing Address - Phone:713-266-7673
Mailing Address - Fax:713-266-4744
Practice Address - Street 1:2405 S GESSNER RD
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2000
Practice Address - Country:US
Practice Address - Phone:713-266-7673
Practice Address - Fax:713-266-4744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-31
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty