Individual
CARY DALE DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1106 CLAYTON LN STE 102W, AUSTIN, TX 78723-2433
(512) 872-6868
Mailing address
1106 CLAYTON LN STE 102W, AUSTIN, TX 78723-2433
(512) 872-6868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J3085
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J3085
LICENSE NUMBER
TX
Enumeration date
08/10/2006
Last updated
05/20/2025
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