Provider Demographics
NPI:1780809715
Name:PRICE, DEBORAH RENNER (AUD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:RENNER
Last Name:PRICE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5462 GLEN LAKES DR.
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-987-4114
Mailing Address - Fax:214-239-9030
Practice Address - Street 1:5462 GLEN LAKES DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-987-4114
Practice Address - Fax:214-239-9030
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90453237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX90453OtherAU.D