Healthcare Provider Details

I. General information

NPI: 1215517669
Provider Name (Legal Business Name): KELSEY AKARUE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 N IH 35 STE 200
ROUND ROCK TX
78664-2901
US

IV. Provider business mailing address

1717 N IH 35 STE 200
ROUND ROCK TX
78664-2901
US

V. Phone/Fax

Practice location:
  • Phone: 512-964-6992
  • Fax:
Mailing address:
  • Phone: 512-964-6992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA17834
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: