Provider Demographics
NPI:1700979721
Name:MCKINNEY, DEBORAH (PT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:MCKINNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:387 COUNTY ROAD 4228
Mailing Address - Street 2:
Mailing Address - City:TROUP
Mailing Address - State:TX
Mailing Address - Zip Code:75789
Mailing Address - Country:US
Mailing Address - Phone:972-814-2664
Mailing Address - Fax:
Practice Address - Street 1:387 COUNTY ROAD 4228
Practice Address - Street 2:
Practice Address - City:TROUP
Practice Address - State:TX
Practice Address - Zip Code:75789
Practice Address - Country:US
Practice Address - Phone:972-814-2664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140812225100000X
VA2305204803225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist