Provider Demographics
NPI:1326144304
Name:COMBS CANTRELL, DEBORAH T (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:T
Last Name:COMBS CANTRELL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 STATE HIGHWAY 121 BYP
Mailing Address - Street 2:BUILDING A STE 150
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8214
Mailing Address - Country:US
Mailing Address - Phone:469-312-1130
Mailing Address - Fax:972-459-7221
Practice Address - Street 1:405 STATE HIGHWAY 121 BYP
Practice Address - Street 2:BUILDING A STE 150
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8214
Practice Address - Country:US
Practice Address - Phone:469-312-1130
Practice Address - Fax:972-459-7221
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH19372084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136311102Medicaid
TX8F5930Medicare PIN
TX136311102Medicaid