Provider Demographics
NPI:1033691746
Name:DUNCAN, MALCOLM (MSN, RN, PMHNP)
Entity Type:Individual
Prefix:
First Name:MALCOLM
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:MSN, RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 MIRA LOMA LN STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1411
Mailing Address - Country:US
Mailing Address - Phone:512-470-5600
Mailing Address - Fax:
Practice Address - Street 1:7005 MIRA LOMA LN STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1411
Practice Address - Country:US
Practice Address - Phone:512-470-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX661686363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health