Pennington, Debra
Pennington, Debra is an individual health care provider with primary practice located at 12554 Riata Vista Cir , Austin TX 78727-6431. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Radiology, which is considered as her primary health care specialty. Pennington, Debra can be contacted via phone (512) 795-5100.Contact Information
Primary practice address
12554 Riata Vista Cir
Austin TX 78727-6431
Phone: (512) 795-5100
Fax: (512) 795-5122
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | K8416 | Texas |
Profile Details
| NPI number | 1891799417 |
|---|---|
| LBN Legal business name | Pennington, Debra |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Jan 13th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891799417 | NPPES |
| Texas | Other | 105706903 | CSHCN1 |
| Texas | Other | 300108480 | CSHCN1 |
| Texas | Other | 300127115 | CSHCN1 |
| Texas | Other | 105706904 | CSHCN1 |
| Texas | MEDICAID | 105706901 | CSHCN1 |
| Texas | MEDICAID | 105706902 | CSHCN1 |
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