Individual
STEPHANIE LOUISE TACQUARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1301 BARBARA JORDAN BLVD, SUITE 200, AUSTIN, TX 78723-3077
(512) 628-1830
Mailing address
1301 BARBARA JORDAN BLVD, SUITE 200, AUSTIN, TX 78723-3077
(512) 628-1830
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
N6703
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332004601
—
TX
05
—
332004602
—
TX
Enumeration date
08/31/2012
Last updated
12/09/2014
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