Basic Information
Provider Information
NPI: 1679127542
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEBEY
FirstName: PAUL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 80217
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850600217
CountryCode: US
TelephoneNumber: 6023852115
FaxNumber: 4804183323
Practice Location
Address1: 1675 E MELROSE ST STE 101-103
Address2:  
City: GILBERT
State: AZ
PostalCode: 852971001
CountryCode: US
TelephoneNumber: 6026485444
FaxNumber: 6027723801
Other Information
ProviderEnumerationDate: 07/30/2019
LastUpdateDate: 07/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X2019027904MON Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000X31895AZY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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