Provider Demographics
NPI:1912908807
Name:EKERY, DEBORAH L (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:EKERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7800 SHOAL CREEK BLVD
Mailing Address - Street 2:SUITE 205N
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1098
Mailing Address - Country:US
Mailing Address - Phone:512-206-4300
Mailing Address - Fax:512-206-4350
Practice Address - Street 1:3801 N LAMAR BLVD
Practice Address - Street 2:STE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4080
Practice Address - Country:US
Practice Address - Phone:512-206-3600
Practice Address - Fax:512-454-2581
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ7322207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1540965-01Medicaid
TXTXB117095Medicare PIN
TX8A0306Medicare PIN
TX1540965-01Medicaid