Individual
MRS. LARISSA DEBLANC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
4055 VALLEY VIEW LN, DALLAS, TX 75244-5074
(972) 715-3800
Mailing address
1495 N 7TH ST, BEAUMONT, TX 77702-1345
(409) 832-3377
(877) 547-8271
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP133520
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP133520
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381679501
—
TX
Enumeration date
03/06/2017
Last updated
02/11/2025
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