MEDICARE: DR. LYNNE TANNER INMAN M.D

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
1	2084P0800X	Psychiatry Physician	G8456	TX

General Provider Information

NPI Number	:	1346271905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNNE TANNER INMAN M.D

Provider Business Mailing Address
First Line	:	4110 GUADALUPE ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-4223
Country	:	US
Telephone Number	:	512-452-0381
Fax Number	:	512-419-2683

Provider Business Practice Location Address
First Line	:	4110 GUADALUPE ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78751-4223
Country	:	US
Telephone Number	:	512-452-0381
Fax Number	:	512-419-2683

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/08/2007

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