Provider Demographics
NPI:1770681462
Name:DEUBNER, KEVIN PAUL
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:PAUL
Last Name:DEUBNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 PEAVY RD SUITE 5
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-4009
Mailing Address - Country:US
Mailing Address - Phone:214-321-8028
Mailing Address - Fax:214-328-0317
Practice Address - Street 1:1606 PEAVY RD
Practice Address - Street 2:SUITE 5
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-3624
Practice Address - Country:US
Practice Address - Phone:214-321-8028
Practice Address - Fax:214-328-0317
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0085689332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies