Provider Demographics
NPI:1851069603
Name:DAVID, DEEPA L (NP)
Entity Type:Individual
Prefix:
First Name:DEEPA
Middle Name:L
Last Name:DAVID
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 W MOORE AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-2372
Mailing Address - Country:US
Mailing Address - Phone:972-210-7350
Mailing Address - Fax:972-210-7355
Practice Address - Street 1:1446 W MOORE AVE STE 206
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2372
Practice Address - Country:US
Practice Address - Phone:972-210-7350
Practice Address - Fax:972-210-7355
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-04
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP137361363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics