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Individual

DEBORAH ANN BLACKSHIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6620 MAIN ST, HOUSTON, TX 77030-2348
(713) 798-5700
Mailing address
7123 WINDWATER PKWY S, HOUSTON, TX 77036-3220
(832) 433-7077

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA03682
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
182269401
TX
Enumeration date
07/27/2006
Last updated
07/03/2008
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