Provider Demographics
NPI:1063704740
Name:DUVAL, DEBORAH (LAC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:DUVAL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BRIANNE ST
Mailing Address - Street 2:
Mailing Address - City:JOSHUA
Mailing Address - State:TX
Mailing Address - Zip Code:76058-4750
Mailing Address - Country:US
Mailing Address - Phone:817-484-9148
Mailing Address - Fax:
Practice Address - Street 1:108 BRIANNE ST
Practice Address - Street 2:
Practice Address - City:JOSHUA
Practice Address - State:TX
Practice Address - Zip Code:76058-4750
Practice Address - Country:US
Practice Address - Phone:817-484-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01206171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist