Healthcare Provider Details

I. General information

NPI: 1235043472
Provider Name (Legal Business Name): DENISE LAVENDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 BEE CAVES RD
AUSTIN TX
78746-5642
US

IV. Provider business mailing address

5504 WAGON TRAIN RD
AUSTIN TX
78749-2143
US

V. Phone/Fax

Practice location:
  • Phone: 512-899-8686
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC01148
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: