Provider Demographics
NPI:1689679227
Name:COOPER-NEWLAND, DEBORAH LEE (DDS PLLC)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LEE
Last Name:COOPER-NEWLAND
Suffix:
Gender:F
Credentials:DDS PLLC
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:LEE
Other - Last Name:NEWLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5001 BISSONNET ST
Mailing Address - Street 2:STE 103
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4015
Mailing Address - Country:US
Mailing Address - Phone:713-592-9336
Mailing Address - Fax:713-592-9337
Practice Address - Street 1:5001 BISSONNET ST
Practice Address - Street 2:STE 103
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4015
Practice Address - Country:US
Practice Address - Phone:713-592-9336
Practice Address - Fax:713-592-9337
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX177931223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
760445216OtherTAX ID
TXD17793OtherBCBS ID
TX17793OtherSTATE LICENSE
TXD17793Medicare ID - Type Unspecified
760445216OtherTAX ID