Provider Demographics
NPI:1285895672
Name:MABULAC, DEBORAH CEPEDA (NP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:CEPEDA
Last Name:MABULAC
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 S MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9152
Mailing Address - Country:US
Mailing Address - Phone:956-971-5527
Mailing Address - Fax:956-971-5527
Practice Address - Street 1:5501 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9152
Practice Address - Country:US
Practice Address - Phone:956-971-5525
Practice Address - Fax:956-971-5527
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX504807363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner