Healthcare Provider Details

I. General information

NPI: 1275548331
Provider Name (Legal Business Name): WENDY LANKFORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 02/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13359 N HWY 183 STE 403
AUSTIN TX
78750-7154
US

IV. Provider business mailing address

3117 WILD CANYON LOOP
AUSTIN TX
78732-1948
US

V. Phone/Fax

Practice location:
  • Phone: 512-867-6200
  • Fax: 512-519-1127
Mailing address:
  • Phone: 512-266-2945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL9303
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: