Basic Information
| Provider Information | |||||||||
| NPI: | 1326401092 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NEWCUM | ||||||||
| FirstName: | DEBORAH | ||||||||
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| Credential: | OTR, MED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 956 BENBOW RD | ||||||||
| Address2: | |||||||||
| City: | INEZ | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779683309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3616762704 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3103 E AIRLINE RD | ||||||||
| Address2: | |||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779014546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615756457 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2016 | ||||||||
| LastUpdateDate: | 03/31/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XG0600X | 101979 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Gerontology |
No ID Information.