Provider Demographics
NPI:1487677829
Name:THEIS, DEBORAH E (PHD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:THEIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:E
Other - Last Name:THEIS-HEDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:4314 YOAKUM BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5818
Mailing Address - Country:US
Mailing Address - Phone:713-850-0049
Mailing Address - Fax:713-627-7302
Practice Address - Street 1:4314 YOAKUM BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5818
Practice Address - Country:US
Practice Address - Phone:713-850-0049
Practice Address - Fax:713-627-7302
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25778103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102775710Medicaid
TX102775711Medicaid
TX102775712Medicaid
TX88186AOtherBCBS TX HOUSTON
TX1025775701Medicaid
TX102775702Medicaid
TX102775704Medicaid
TX102775705Medicaid
TX102775707Medicaid
TX102775709Medicaid
TX102775708Medicaid
TXP00997619OtherRR MCR
TXP01010614OtherRR MCR
TX102775706Medicaid
TX88336AOtherBCBS TX
TXP00961151OtherRR MCR
TXP01011570OtherRR MCR
TXTXB141767Medicare PIN
TXTXB141768Medicare PIN
TXTXB136675Medicare PIN
TXTXB146584Medicare PIN
TXTXB147049Medicare PIN
TX88186AOtherBCBS TX HOUSTON
TX82426WMedicare ID - Type UnspecifiedDOCS TX
TX102775702Medicaid
TXTXB149245Medicare PIN
TX102775708Medicaid
TX102775706Medicaid
TX1025775701Medicaid
TXTXB136676Medicare PIN
TXTXB148071Medicare PIN
TXTXB144699Medicare PIN