Macy Debord

Individual provider Active NPI Licensed Vocational Nurse · Bowie, TX

NPI 1780225136 · NPPES record last updated Oct 7, 2019

Key facts

NPI
1780225136
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
311992 (TX)
Practice address
704 E Nelson St
Bowie, TX 76230-3806
Phone
(940) 224-7650
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
311992TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 311992 TX Yes

Addresses

Primary practice location

704 E Nelson St
Bowie, TX 76230-3806

Mailing address

704 E Nelson St
Bowie, TX 76230-3806

Other providers in Bowie, TX

All providers in Bowie, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.