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Individual

MRS. LOIS A BACHUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1221 W BEN WHITE BLVD, SUITE B-250, AUSTIN, TX 78704-6888
(512) 462-1717
(512) 462-0822
Mailing address
1221 W BEN WHITE BLVD, SUITE B-250, AUSTIN, TX 78704-6888
(512) 462-1717
(512) 462-0822

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
G7033
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0832479-01
TX
05
1229171-03
TX
01
130305100
FIRST CARE ID
TX
01
88M092
BCBS--INDIVIDUAL
TX
01
G7033
TX LICENSE
TX
Enumeration date
11/20/2006
Last updated
07/07/2010
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