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Individual

SHAUN PATRICK MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4101 JAMES CASEY ST STE 100, AUSTIN, TX 78745-1145
(512) 421-4250
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987

Taxonomy

Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
43479
KY
2086X0206X
Surgical Oncology Physician
Primary
P6220
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
330383602
TX
05
330383603
TX
05
330383604
TX
05
330383605
TX
01
P01867717
RAILROAD
TX
Enumeration date
07/02/2008
Last updated
11/05/2019
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