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Individual

MICHAL A DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
711 W 38TH ST, BLDG. F, AUSTIN, TX 78705-1121
(512) 458-6121
(512) 452-9171
Mailing address
711 W 38TH ST, BLDG. F, AUSTIN, TX 78705-1121
(512) 458-6121
(512) 452-9171

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G2686
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1381105 06
TX
Enumeration date
09/20/2006
Last updated
12/27/2011
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