Individual
DR. LYNN MARIE THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
313 E 12TH ST, AUSTIN, TX 78701-1954
(409) 772-2222
Mailing address
629 KINGFISHER CREEK DR, AUSTIN, TX 78748-2428
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N0505
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3805159117
MYUTMB 3805159117-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
08/28/2008
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