Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | N0960 | TX |
NPI | 1033372586 |
---|---|
Provider Name | Amy Ayres Mcclung |
First Address | Austin, TX 78748-6283 |
Second Address | Austin, TX 78748-6283 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2008 |
Last Update Date | 04/08/2017 |