Provider Demographics
NPI:1376823435
Name:ECHAVEZ-DORIA, DEANNA (MSN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:ECHAVEZ-DORIA
Suffix:
Gender:F
Credentials:MSN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 S LOOP 336 W STE 110
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3320
Mailing Address - Country:US
Mailing Address - Phone:936-539-8190
Mailing Address - Fax:
Practice Address - Street 1:690 S LOOP 336 W STE 110
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3320
Practice Address - Country:US
Practice Address - Phone:936-539-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX908768163W00000X
NY575222163W00000X
TX1011649363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse