Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | R6771 | TX |
NPI | 1033484415 |
---|---|
Provider Name | Dr. Macey Renault Delcambre |
First Address | Austin, TX 78746-4721 |
Second Address | Austin, TX 78746 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2012 |
Last Update Date | 06/02/2019 |