Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 656930 | TX |
NPI | 1073898896 |
---|---|
Provider Name | Miss Deborah Lynn Borgman |
First Address | Houston, TX 77082-2432 |
Second Address | Houston, TX 77082-2432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2011 |
Last Update Date | 12/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NO NUMBER YET | APPLYING (01) |