Individual
LUCILE BORDEN TENNANT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 E 15TH ST, PATHOLOGY DEPARTMENT, AUSTIN, TX 78701-1930
(812) 324-7516
(512) 324-7536
Mailing address
PO BOX 164106, AUSTIN, TX 78716-4106
(512) 324-7516
(512) 324-7536
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
202858
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
209822
MA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
46948
WI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
J2370
TX
Other
Enumeration date
11/07/2005
Last updated
07/08/2007
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