Healthcare Provider Details

I. General information

NPI: 1578475661
Provider Name (Legal Business Name): JENNEFER CAROLINA DURAN DELCID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 CROSS PARK DR
AUSTIN TX
78754-4595
US

IV. Provider business mailing address

608 MEADOWCREEK CV
ROUND ROCK TX
78664-6022
US

V. Phone/Fax

Practice location:
  • Phone: 512-823-0570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number1032275
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1032275
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: