Provider Demographics
NPI:1699325928
Name:MCCUTCHEN, DEIDRA ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:DEIDRA
Middle Name:ELIZABETH
Last Name:MCCUTCHEN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:400 CONCORD PLAZA DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6991
Mailing Address - Country:US
Mailing Address - Phone:210-804-5416
Mailing Address - Fax:210-678-4142
Practice Address - Street 1:2829 BABCOCK RD STE 700
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6015
Practice Address - Country:US
Practice Address - Phone:210-593-1475
Practice Address - Fax:210-593-1478
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2020-01-10
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant