Individual
DESTANI DEFUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16044 COUNTY ROAD 165, TYLER, TX 75703-7302
(903) 526-5599
Mailing address
1009 BLACKJACK CT, CHANDLER, TX 75758-0170
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2188638
TX
Other
Enumeration date
08/10/2026
Last updated
08/10/2026
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