Healthcare Provider Details

I. General information

NPI: 1043510894
Provider Name (Legal Business Name): LISA FRANCIS PLOTKIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 WALLINGWOOD DRIVE BUILDING 11 SUITE 200
AUSTIN TX
78746-7874
US

IV. Provider business mailing address

7630 WOOD HOLLOW DR APT 241
AUSTIN TX
78731-2216
US

V. Phone/Fax

Practice location:
  • Phone: 512-744-5489
  • Fax: 512-287-5575
Mailing address:
  • Phone: 954-643-2861
  • Fax: 512-287-5575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA06940
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: