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NPI Code Detail

MEDICARE: CLAIRE MCDONOUGH PMHNP-BC

MEDICARE:   CLAIRE  MCDONOUGH  PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner808652TX

General Provider Information

NPI Number : 1023442142
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAIRE MCDONOUGH PMHNP-BC
Provider Business Mailing Address
First Line : 7005 MIRA LOMA LN
Second Line :
City : AUSTIN
State : TX
Zip : 78723-1411
Country : US
Telephone Number : 512-795-4344
Fax Number :
Provider Business Practice Location Address
First Line : 7005 MIRA LOMA LN
Second Line :
City : AUSTIN
State : TX
Zip : 78723-1411
Country : US
Telephone Number : 512-795-4344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2013
Last Update Date : 08/26/2013

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Directions to “ CLAIRE MCDONOUGH PMHNP-BC” Practice Location

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