Individual
DR. LETITIA EILEEN PHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5656 BEE CAVES RD. BLDG C STE. 102, AUSTIN, TX 78746
(512) 323-5465
(512) 327-1390
Mailing address
PO BOX 13442, AUSTIN, TX 78711-3442
(512) 323-5465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
K1277
TX
208M00000X
Hospitalist Physician
Primary
K1277
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029957-02
—
TX
05
—
102995702
—
TX
Enumeration date
06/23/2006
Last updated
02/20/2020
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