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General NPI Number Information
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NPI Number | 1174495758
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Entity Type | Individual
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Provider Name | LAUREN PRENDEVILLE
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Gender | Female
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 300 UNIVERSITY BLVD
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City | ROUND ROCK
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State | TX
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Zip | 78665-1032
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Country | US
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Telephone | 512-509-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 1273 PINE FOREST CIR
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City | ROUND ROCK
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State | TX
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Zip | 78665-5648
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Country | US
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Telephone | 512-968-2419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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