Individual
MS. DIANE M. HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5504 BURGUNDY DR, AUSTIN, TX 78724-3306
(512) 736-4158
Mailing address
5504 BURGUNDY DR, AUSTIN, TX 78724-3306
(512) 736-4158
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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