Debra Sue Mahoney, FNP | |
1600 Broadway Ave, Gladewater, TX 75647-5040 | |
(903) 315-5630 | |
(903) 845-6212 |
Full Name | Debra Sue Mahoney |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 1600 Broadway Ave, Gladewater, Texas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265619241 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | AP109268 (Texas) | Primary |
Entity Name | Christus Trinity Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285684225 PECOS PAC ID: 3072426741 Enrollment ID: O20031204001091 |
Mailing Address | Practice Location Address |
---|---|
Debra Sue Mahoney, FNP Po Box 4207, Longview, TX 75606-4207 Ph: (903) 315-4105 | Debra Sue Mahoney, FNP 1600 Broadway Ave, Gladewater, TX 75647-5040 Ph: (903) 315-5630 |
Tracy Casey, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1600 Broadway Ave, Gladewater, TX 75647 Phone: 903-315-5630 | |
Macy Santee, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 307 W Upshur Ave, Gladewater, TX 75647 Phone: 903-845-2159 Fax: 903-845-5451 | |
Mrs. Dawn Rae Livingston, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 658 Pyeatt Dr, Gladewater, TX 75647 Phone: 903-239-3239 | |
Cassandra Ford, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 307 W Upshur Ave, Gladewater, TX 75647 Phone: 903-845-2159 Fax: 903-845-5451 |