Provider Demographics
NPI:1740259852
Name:CHESTER, DEBRA K (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:K
Last Name:CHESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:WOODWARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:300 HENERETTA DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2242
Mailing Address - Country:US
Mailing Address - Phone:999-999-9999
Mailing Address - Fax:999-999-9999
Practice Address - Street 1:300 HENERETTA DR
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2242
Practice Address - Country:US
Practice Address - Phone:999-999-9999
Practice Address - Fax:999-999-9999
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2360207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138813414Medicaid
TXD95807Medicare UPIN