Individual
LOGAN DEBORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
984 N 10 MILE DR, #103, FRISCO, CO 80443-5719
(970) 668-0998
Mailing address
7300 RANCH ROAD 2222, BUILDING 1, STE 200, AUSTIN, TX 78730
(512) 628-0465
(512) 233-2711
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
DR.0069923
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2019
Last updated
02/24/2023
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