Provider Demographics
NPI:1023658036
Name:QUICK, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:QUICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14200 COUNTY ROAD 358
Mailing Address - Street 2:
Mailing Address - City:BLANKET
Mailing Address - State:TX
Mailing Address - Zip Code:76432-4617
Mailing Address - Country:US
Mailing Address - Phone:325-647-5894
Mailing Address - Fax:
Practice Address - Street 1:14200 COUNTY ROAD 358
Practice Address - Street 2:
Practice Address - City:BLANKET
Practice Address - State:TX
Practice Address - Zip Code:76432-4617
Practice Address - Country:US
Practice Address - Phone:325-647-5894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500539163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse