Provider Demographics
NPI:1114114840
Name:DUFFIELD-HOLMES, DEBEIA
Entity Type:Individual
Prefix:
First Name:DEBEIA
Middle Name:
Last Name:DUFFIELD-HOLMES
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 1:6429 S FM 225
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-1396
Mailing Address - Country:US
Mailing Address - Phone:409-381-9362
Mailing Address - Fax:
Practice Address - Street 1:6429 S FM 225
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75964-1396
Practice Address - Country:US
Practice Address - Phone:409-381-9362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies