Provider Demographics
NPI:1720165566
Name:TRIMBLE, DEBRA (PHD, NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:TRIMBLE
Suffix:
Gender:F
Credentials:PHD, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE BAYLOR PLAZA
Mailing Address - Street 2:MAILSTOP: BCM286
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-873-4105
Mailing Address - Fax:711-387-3410
Practice Address - Street 1:2015 THOMAS STREET
Practice Address - Street 2:ROOM 201B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009
Practice Address - Country:US
Practice Address - Phone:713-873-4105
Practice Address - Fax:713-873-4106
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX542207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX09273672OtherTX DRIVERS LICENSE
TX09273672OtherTX DRIVERS LICENSE