Provider Demographics
NPI:1023280757
Name:MYERS, DEBRA J (BC-HIS)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:MYERS
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5925 FOREST LN STE 411
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2767
Mailing Address - Country:US
Mailing Address - Phone:817-804-0403
Mailing Address - Fax:817-804-0403
Practice Address - Street 1:2225 W PARK ROW DR STE H
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013
Practice Address - Country:US
Practice Address - Phone:817-804-0403
Practice Address - Fax:817-804-0403
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09055517237700000X
TX80254237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist