# DEUTERONOMY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013938125
- **Authorized official:** DEBI GLICK (VP ADMIN)
- **Authorized official phone:** (972) 792-5700

## Contact information

- **Practice address:** 1604 HOSPITAL PKWY, SUITE 100, BEDFORD, TX 76022-6986
- **Practice address phone:** (972) 792-5700
- **Mailing address:** PO BOX 910042, DALLAS, TX 75391-0042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 12/10/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00846K | BCBS | TX |