Provider Demographics
NPI:1700766912
Name:ANTICH, DEBORAH SUE (RSPS)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUE
Last Name:ANTICH
Suffix:
Gender:F
Credentials:RSPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2904
Mailing Address - Country:US
Mailing Address - Phone:512-496-4284
Mailing Address - Fax:
Practice Address - Street 1:613 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-2904
Practice Address - Country:US
Practice Address - Phone:512-496-4284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1645-1022175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist