Healthcare Provider Details

I. General information

NPI: 1134157183
Provider Name (Legal Business Name): MARY NANCY DARDEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SETTLEMENT DR SUITE B
BASTROP TX
78602
US

IV. Provider business mailing address

1009 N GEORGETOWN ST
ROUND ROCK TX
78664-3289
US

V. Phone/Fax

Practice location:
  • Phone: 512-303-5689
  • Fax: 512-321-6400
Mailing address:
  • Phone: 512-244-8374
  • Fax: 512-244-8371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG2087
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: