MEDICARE: ALLYSON ALEXIS CLENDENNEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		TX

General Provider Information

NPI Number	:	1003743816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSON ALEXIS CLENDENNEN

Provider Business Mailing Address
First Line	:	2001 PLATEAU VISTA BLVD APT 6204
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-2916
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13435 N US HIGHWAY 183 STE 302
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-3258
Country	:	US
Telephone Number	:	512-250-5300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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Directions to “ ALLYSON ALEXIS CLENDENNEN ” Practice Location

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