Healthcare Provider Details

I. General information

NPI: 1639648264
Provider Name (Legal Business Name): KRISTIN LASSETER, MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2018
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4022 MENCHACA RD
AUSTIN TX
78704-6746
US

IV. Provider business mailing address

4022 MENCHACA RD
AUSTIN TX
78704-6746
US

V. Phone/Fax

Practice location:
  • Phone: 512-982-4116
  • Fax: 512-265-9008
Mailing address:
  • Phone: 512-982-4116
  • Fax: 512-265-9008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTIN YEUNG LASSETER
Title or Position: MEMBER
Credential: MD
Phone: 512-982-4116