Provider Demographics
NPI:1841559788
Name:MAHAN, DEBORAH D (RN BSN)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:D
Last Name:MAHAN
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BROADWAY ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7771
Mailing Address - Country:US
Mailing Address - Phone:512-393-5520
Mailing Address - Fax:512-393-5530
Practice Address - Street 1:401 BROADWAY ST STE A
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7771
Practice Address - Country:US
Practice Address - Phone:512-393-5520
Practice Address - Fax:512-393-5530
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-13
Last Update Date:2012-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator