Provider Demographics
NPI:1508822511
Name:HAJOVSKY, DEBORAH R (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:R
Last Name:HAJOVSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22000
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76902-7200
Mailing Address - Country:US
Mailing Address - Phone:325-747-1511
Mailing Address - Fax:
Practice Address - Street 1:220 E HARRIS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-5906
Practice Address - Country:US
Practice Address - Phone:325-747-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9972207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84051FOtherBLUE CROSS/BLUE SHIELD TX
TX123650703Medicaid
TX123650703Medicaid
TX84051FMedicare ID - Type Unspecified