Provider Demographics
NPI:1780063131
Name:DEUBS HOME VISITS LLC
Entity type:Organization
Organization Name:DEUBS HOME VISITS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANDRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:DEUBOUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-241-0099
Mailing Address - Street 1:2088 BRONCO LN
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3139
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2088 BRONCO LN
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3139
Practice Address - Country:US
Practice Address - Phone:862-241-0099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty