Healthcare Provider Details

I. General information

NPI: 1205747045
Provider Name (Legal Business Name): ASMITA GYAWALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 MEDICAL PKWY STE 200
CEDAR PARK TX
78613-2778
US

IV. Provider business mailing address

1309 SUNSET HILL WAY
GEORGETOWN TX
78628-4385
US

V. Phone/Fax

Practice location:
  • Phone: 512-341-2895
  • Fax: 512-341-2895
Mailing address:
  • Phone: 310-910-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1244012
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: