Provider Demographics
NPI:1295829497
Name:RICKENBACKER, DENAE WAUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:DENAE
Middle Name:WAUGH
Last Name:RICKENBACKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11901 W PARMER LN
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-690-2075
Mailing Address - Fax:512-259-3576
Practice Address - Street 1:11901 W PARMER LN
Practice Address - Street 2:SUITE 310
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-690-2075
Practice Address - Fax:512-259-3576
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM37102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry