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Individual

DR. JAYNE SUZANNE TRUCKENBROD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
4900 MUELLER BLVD, AUSTIN, TX 78723-3079
(512) 324-0165
Mailing address
1601 RIO GRANDE ST, SUITE 340, AUSTIN, TX 78701-1137
(512) 324-8960

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
P7718
TX
208M00000X
Hospitalist Physician
Primary
P7718
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
328476201
TX
05
328476202
TX
05
328476203
TX
Enumeration date
08/05/2007
Last updated
10/15/2018
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