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Individual

JENNIFER C PANNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1807 W SLAUGHTER LN, #490, AUSTIN, TX 78748-6208
(512) 282-8967
(512) 292-5143
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 421-4489

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L6560
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
170903201
TX
05
170903202
TX
05
170903203
TX
05
170903204
TX
Enumeration date
07/31/2006
Last updated
06/01/2011
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