Provider Demographics
NPI:1851673404
Name:TEIXEIRA, DEBORA MARTHA (PA-C)
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:MARTHA
Last Name:TEIXEIRA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DEBORA
Other - Middle Name:M
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-3208
Mailing Address - Country:US
Mailing Address - Phone:650-742-2000
Mailing Address - Fax:877-738-4262
Practice Address - Street 1:1200 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-3208
Practice Address - Country:US
Practice Address - Phone:650-742-2000
Practice Address - Fax:877-738-4262
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21794363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant