Individual
MARY QUINN FASSNACHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
4900 MUELLER BLVD RM 3J.015, AUSTIN, TX 78723-3051
(512) 324-0197
Mailing address
4900 MUELLER BLVD RM 3J.015, AUSTIN, TX 78723-3051
(512) 324-0197
(512) 969-6537
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1011145
TX
Other
Enumeration date
08/09/2020
Last updated
08/16/2024
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