Provider Demographics
NPI:1720351505
Name:RINGSDORF, LILLIAN MACON (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:MACON
Last Name:RINGSDORF
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 OAK HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5088
Mailing Address - Country:US
Mailing Address - Phone:205-410-2374
Mailing Address - Fax:
Practice Address - Street 1:1100 W 49TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3101
Practice Address - Country:US
Practice Address - Phone:210-284-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP19212083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine