Provider Demographics
NPI:1326144304
Name:COMBS CANTRELL, DEBORAH T (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:T
Last Name:COMBS CANTRELL
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:405 STATE HIGHWAY 121 BYP
Mailing Address - Street 2:BUILDING A STE 150
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8214
Mailing Address - Country:US
Mailing Address - Phone:972-869-3448
Mailing Address - Fax:972-405-7729
Practice Address - Street 1:405 STATE HIGHWAY 121 BYP
Practice Address - Street 2:BUILDING A STE 150
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8214
Practice Address - Country:US
Practice Address - Phone:972-869-3448
Practice Address - Fax:972-405-7729
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH19372084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136311102Medicaid
TX8F5930Medicare PIN
TX136311102Medicaid