Individual
DR. DEBRA PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Mailing address
12554 RIATA VISTA CIR, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
K8416
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105706901
—
TX
05
—
105706902
—
TX
01
—
105706903
CSHCN1
TX
01
—
105706904
CSHCN2
TX
01
—
300108480
RRMCARE
—
01
—
300127115
RRMCARE2
—
Enumeration date
06/10/2005
Last updated
01/13/2015
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