Provider Demographics
NPI:1912910035
Name:WARD, TINA ELAINE (MD)
Entity type:Individual
Prefix:DR
First Name:TINA
Middle Name:ELAINE
Last Name:WARD
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Gender:F
Credentials:MD
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Mailing Address - Street 1:11651 JOLLYVILLE RD
Mailing Address - Street 2:#150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3931
Mailing Address - Country:US
Mailing Address - Phone:512-258-6144
Mailing Address - Fax:512-258-6234
Practice Address - Street 1:11651 JOLLYVILLE RD
Practice Address - Street 2:#150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3931
Practice Address - Country:US
Practice Address - Phone:512-258-6144
Practice Address - Fax:512-258-6234
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-13
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Provider Licenses
StateLicense IDTaxonomies
TXK5424207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine