Provider Demographics
NPI:1104062736
Name:PURNELL, DEBRA LEE (OTR)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:LEE
Last Name:PURNELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:108 HUNTERS BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1207
Mailing Address - Country:US
Mailing Address - Phone:210-493-8060
Mailing Address - Fax:210-493-7021
Practice Address - Street 1:3453 IH 35 N STE 211
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78219-2338
Practice Address - Country:US
Practice Address - Phone:210-228-0215
Practice Address - Fax:210-495-8212
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-03
Last Update Date:2009-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102423225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist