Provider Demographics
NPI:1194948372
Name:HARTMAN, DEBORAH KOCH (RN, MSN, CNM)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:KOCH
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:RN, MSN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 OYSTER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3251
Mailing Address - Country:US
Mailing Address - Phone:281-240-3133
Mailing Address - Fax:713-793-1299
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 1812
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-790-4500
Practice Address - Fax:713-793-1299
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX539469367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS61499Medicare UPIN
TX80212MMedicare ID - Type Unspecified