Provider Demographics
NPI:1215521620
Name:WINDER, DEBORAH CASEY (LAT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:CASEY
Last Name:WINDER
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 HIGHLAND VIEW RD
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-9676
Mailing Address - Country:US
Mailing Address - Phone:903-790-4611
Mailing Address - Fax:
Practice Address - Street 1:3002 PARKRIDGE DR
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-2228
Practice Address - Country:US
Practice Address - Phone:940-497-1430
Practice Address - Fax:940-497-1523
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT20382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer