Provider Demographics
NPI:1245423680
Name:SMITH, DEBORAH RUTH
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:RUTH
Last Name:SMITH
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 1:7176 DRUMMOND DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8638
Mailing Address - Country:US
Mailing Address - Phone:972-505-1409
Mailing Address - Fax:972-505-1409
Practice Address - Street 1:4300 MACARTHUR AVE STE 205
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-6566
Practice Address - Country:US
Practice Address - Phone:214-599-9285
Practice Address - Fax:214-599-9285
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108042225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist