Provider Demographics
NPI:1639394562
Name:TAMRA K. DEUSER, M.D., P.A.
Entity Type:Organization
Organization Name:TAMRA K. DEUSER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:DEUSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-899-8200
Mailing Address - Street 1:2601 FLOWER MOUND ROAD
Mailing Address - Street 2:SUITE 133
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-4202
Mailing Address - Country:US
Mailing Address - Phone:972-899-8200
Mailing Address - Fax:972-899-8202
Practice Address - Street 1:2601 FLOWER MOUND RD
Practice Address - Street 2:133
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-4202
Practice Address - Country:US
Practice Address - Phone:972-899-8200
Practice Address - Fax:972-899-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3951261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL3951OtherSTATE LICENSE
TX1770578650OtherINDIVIDUAL NPI
TX00X400Medicare PIN
TXL3951OtherSTATE LICENSE