Healthcare Provider Details

I. General information

NPI: 1316641749
Provider Name (Legal Business Name): LAUREN LEA WILLIAMS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 E SLAUGHTER LN STE 404
AUSTIN TX
78744-2156
US

IV. Provider business mailing address

709 E SLAUGHTER LN STE 404
AUSTIN TX
78744-2156
US

V. Phone/Fax

Practice location:
  • Phone: 512-277-6643
  • Fax: 512-888-1202
Mailing address:
  • Phone: 512-277-6643
  • Fax: 512-888-1202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA16701
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA16701
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: