Provider Demographics
NPI:1881658482
Name:NEITSCH, DEBORAH K (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:NEITSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4112 LINKS LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-3901
Mailing Address - Country:US
Mailing Address - Phone:512-672-8933
Mailing Address - Fax:512-672-8937
Practice Address - Street 1:4112 LINKS LN
Practice Address - Street 2:SUITE 201
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-3901
Practice Address - Country:US
Practice Address - Phone:512-672-8933
Practice Address - Fax:512-672-8937
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL4595207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152746701Medicaid
TX1527467-04Medicaid
TXH65702Medicare UPIN
TX1527467-04Medicaid
TX152746701Medicaid
TXTXB117232Medicare PIN