Provider Demographics
NPI:1548878820
Name:HLAVIN, DEBORAH MICHELLE (FNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MICHELLE
Last Name:HLAVIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:MICHELLE
Other - Last Name:GORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:4037 CRESTMONT DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-2073
Mailing Address - Country:US
Mailing Address - Phone:979-204-5403
Mailing Address - Fax:
Practice Address - Street 1:4630 LONG PRAIRIE RD STE 210
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1964
Practice Address - Country:US
Practice Address - Phone:469-495-9112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142146363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily