Provider Demographics
NPI:1760430219
Name:DEUBER, CHRISTINA G (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:G
Last Name:DEUBER
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 1:5470 W. LOVERS LANE STE 330
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209
Mailing Address - Country:US
Mailing Address - Phone:214-956-7337
Mailing Address - Fax:469-364-8724
Practice Address - Street 1:5470 W. LOVERS LANE STE 330
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209
Practice Address - Country:US
Practice Address - Phone:214-956-7337
Practice Address - Fax:469-364-8724
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0713208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX050622563 TIN PLLCOtherWESTCHESTER PEDIATRICS
TX752660211OtherTAXPAYOR NUMBER
TXK0713OtherMEDICL LICENSE