Provider Demographics
NPI:1487239976
Name:DEBEBE, BETH
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:DEBEBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 E 15TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5712
Mailing Address - Country:US
Mailing Address - Phone:469-914-0029
Mailing Address - Fax:469-754-0412
Practice Address - Street 1:704 E 15TH ST STE 107
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5712
Practice Address - Country:US
Practice Address - Phone:469-914-0029
Practice Address - Fax:469-754-0412
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker