Provider Demographics
NPI:1770618787
Name:KAGAN, DEBORAH L (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:L
Last Name:KAGAN
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 1:8303 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 330
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1600
Mailing Address - Country:US
Mailing Address - Phone:713-774-2122
Mailing Address - Fax:713-774-3223
Practice Address - Street 1:8303 SOUTHWEST FWY
Practice Address - Street 2:SUITE 330
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1600
Practice Address - Country:US
Practice Address - Phone:713-774-2122
Practice Address - Fax:713-774-3223
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22982103T00000X, 103TA0700X, 103TB0200X, 103TC1900X, 103TF0000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86930AOtherBLUE CROSS & BLUE SHIELD
TX8C8778Medicare ID - Type Unspecified