Provider Demographics
NPI:1134489669
Name:WEBER, DEBORAH (REPT)
Entity Type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:REPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 WATERVIEW PARKWAY
Mailing Address - Street 2:SUITE 305
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-8101
Mailing Address - Country:US
Mailing Address - Phone:214-295-6703
Mailing Address - Fax:214-245-5267
Practice Address - Street 1:3400 WATERVIEW PKWY STE 305
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1472
Practice Address - Country:US
Practice Address - Phone:214-295-6703
Practice Address - Fax:214-245-5267
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1206246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic