Immken, Ladonna L

Immken, Ladonna L is an individual health care provider with primary practice located at 6811 Austin Center Blvd Suite #400, Austin TX 78731-3146. She recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), which is considered as her primary health care specialty. Immken, Ladonna L can be contacted via phone (512) 628-1840.

Contact Information

Primary practice address
6811 Austin Center Blvd Suite #400 Austin TX 78731-3146
Phone: (512) 628-1840
Fax: (512) 628-1840
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) 207SG0201X G4018 Texas

Profile Details

NPI number 1053363531
LBN Legal business name Immken, Ladonna L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jan 10th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053363531 NPPES
Texas MEDICAID 136490301
Texas MEDICAID 136490305

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