Individual
MATTIE MCCLINTOCK ROYALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3705 MEDICAL PKWY STE 570, AUSTIN, TX 78705-1024
(512) 454-2554
Mailing address
PO BOX 2127, ATHENS, TX 75751-7127
(903) 677-1000
(903) 677-1694
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
776975
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP127307
TX
Other
Enumeration date
01/21/2015
Last updated
02/26/2020
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