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General NPI Number Information
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NPI Number | 1447935671
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Entity Type | Individual
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Provider Name | OLIVIA DEXTER PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 200 MEDICAL PKWY STE 220
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City | LAKEWAY
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State | TX
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Zip | 78738-1793
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Country | US
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Telephone | 512-654-4550
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Fax | 512-654-4551
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Provider Business Mailing Address
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Address Line | PO BOX 844658
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City | DALLAS
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State | TX
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Zip | 75284-4658
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Country | US
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Telephone | 800-994-0371
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Fax | 254-215-9722
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA19261
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License Number State | TX
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