Provider Demographics
NPI:1427251255
Name:DEANE, ANGELA CHIVON
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:CHIVON
Last Name:DEANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:A
Other - Middle Name:DESTINY
Other - Last Name:CARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:209 RINEHARDT ST
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-3291
Mailing Address - Country:US
Mailing Address - Phone:512-876-9483
Mailing Address - Fax:512-876-9483
Practice Address - Street 1:209 RINEHARDT ST
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634
Practice Address - Country:US
Practice Address - Phone:512-876-9483
Practice Address - Fax:512-876-9483
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program