Provider Demographics
NPI:1942598008
Name:GREEN, DEBORAH RENEE
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:RENEE
Last Name:GREEN
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 1:5033 DOOLITTLE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-3494
Mailing Address - Country:US
Mailing Address - Phone:832-741-1446
Mailing Address - Fax:
Practice Address - Street 1:5033 DOOLITTLE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-3494
Practice Address - Country:US
Practice Address - Phone:832-741-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility