Provider Demographics
NPI:1841539293
Name:DEANNE DEGREAFFENREIDTE M.D., P.A.
Entity type:Organization
Organization Name:DEANNE DEGREAFFENREIDTE M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGREAFFENREIDTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-329-9057
Mailing Address - Street 1:7 SWITCHBUD PL
Mailing Address - Street 2:SUITE 192-176
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3700
Mailing Address - Country:US
Mailing Address - Phone:214-329-9057
Mailing Address - Fax:
Practice Address - Street 1:17200 ST LUKES WAY
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8007
Practice Address - Country:US
Practice Address - Phone:214-329-9057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN43742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty