Provider Demographics
NPI:1376680678
Name:SHEPPARD, DEBORAH ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:4400 FREDERICKSBURG RD
Mailing Address - Street 2:STE 107
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-1969
Mailing Address - Country:US
Mailing Address - Phone:210-737-1926
Mailing Address - Fax:210-737-2621
Practice Address - Street 1:4400 FREDERICKSBURG RD
Practice Address - Street 2:107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-2031
Practice Address - Country:US
Practice Address - Phone:210-737-1926
Practice Address - Fax:210-737-2621
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX5595T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU78017Medicare UPIN