Provider Demographics
NPI:1801056718
Name:VYBORNY, DEBORAH L (MED)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:L
Last Name:VYBORNY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 YOSEMITE LN
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-1221
Mailing Address - Country:US
Mailing Address - Phone:469-463-6528
Mailing Address - Fax:
Practice Address - Street 1:113 YOSEMITE LN
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-1221
Practice Address - Country:US
Practice Address - Phone:469-463-6528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst