Provider Demographics
NPI:1720274186
Name:ARCHULETA, DEBRA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:J
Last Name:ARCHULETA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8626 TESORO DR STE 490
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6217
Mailing Address - Country:US
Mailing Address - Phone:210-202-0100
Mailing Address - Fax:
Practice Address - Street 1:8626 TESORO DR STE 490
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6217
Practice Address - Country:US
Practice Address - Phone:210-202-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth