Healthcare Provider Details

I. General information

NPI: 1043704620
Provider Name (Legal Business Name): LANKFORD MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3117 WILD CANYON LOOP
AUSTIN TX
78732-1948
US

IV. Provider business mailing address

3117 WILD CANYON LOOP
AUSTIN TX
78732-1948
US

V. Phone/Fax

Practice location:
  • Phone: 512-266-2945
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WENDY LANKFORD
Title or Position: OWNER
Credential: MD
Phone: 512-673-3688