Provider Demographics
NPI:1679666754
Name:HUCABY, DEBORAH S (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:HUCABY
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 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-4095
Practice Address - Fax:682-885-7499
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3892207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11556110OtherFIRSTCARE PIN
TX4526113OtherAETNA PIN
TX865518OtherUHC PIN
TX10028746OtherAMERIGROUP PIN
TX135000104Medicaid
TX110334OtherSUPERIOR PIN
TX137283103Medicaid
TX135000106Medicaid
TX1640319OtherFIRSTHEALTH PIN
TX00L42VOtherBCBSTX GRP PIN
TX139307OtherPHCS PIN
1669442042OtherGRP NPI NUMBER
TX83X006OtherBCBSTX IND PIN
TX137345805Medicaid
TX1523628OtherCIGNA PIN
TX1640319OtherFIRSTHEALTH PIN
E38996Medicare UPIN
TX137283103Medicaid