Provider Demographics
NPI:1124441142
Name:DUCKWORTH, AZUCENA (MD)
Entity type:Individual
Prefix:DR
First Name:AZUCENA
Middle Name:
Last Name:DUCKWORTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 ISLAND WREN DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-4938
Mailing Address - Country:US
Mailing Address - Phone:504-909-4153
Mailing Address - Fax:
Practice Address - Street 1:2113 N HIGHWAY 175
Practice Address - Street 2:
Practice Address - City:SEAGOVILLE
Practice Address - State:TX
Practice Address - Zip Code:75159-2237
Practice Address - Country:US
Practice Address - Phone:972-287-4089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare