Provider Demographics
NPI:1124132584
Name:BOYER, DEBORAH SUE (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:SUE
Last Name:BOYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4312 HIGH MESA DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3253
Mailing Address - Country:US
Mailing Address - Phone:972-867-9212
Mailing Address - Fax:
Practice Address - Street 1:7 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7823
Practice Address - Country:US
Practice Address - Phone:972-888-7265
Practice Address - Fax:214-712-2487
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5530207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E02298Medicare UPIN