| John R Debus Md Pllc | |
|
5477 Glen Lakes Dr Suite 150 Dallas TX 75231-0946 | |
| (214) 373-9300 | |
| (214) 373-9303 |
| Full Name | John R Debus Md Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5477 Glen Lakes Dr, Dallas, Texas |
| Authorized Official Name and Position | John R Debus (PRESIDENT) |
| Authorized Official Contact | 2143739300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John R Debus Md Pllc 5477 Glen Lakes Dr Suite 150 Dallas TX 75231-0946 Ph: (214) 373-9300 | John R Debus Md Pllc 5477 Glen Lakes Dr Suite 150 Dallas TX 75231-0946 Ph: (214) 373-9300 |
| NPI Number | 1427465533 |
|---|---|
| Provider Enumeration Date | 07/21/2014 |
| Last Update Date | 07/21/2014 |
| Medicare PECOS PAC ID | 4587979497 |
|---|---|
| Medicare Enrollment ID | O20150820010720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427465533 | NPI | - | NPPES |
| 1457354094 | Other | TX | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | G8821 (Texas) | Secondary |
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | G8821 (Texas) | Primary |
| Provider Name | John R Debus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457354094 PECOS PAC ID: 5890770051 Enrollment ID: I20040714001471 |
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