Provider Demographics
NPI:1750691556
Name:LAWRENCE, CASSIDY ANNELL (PA-C)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:ANNELL
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4100 DUVAL RD
Mailing Address - Street 2:BLDG 3
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4275
Mailing Address - Country:US
Mailing Address - Phone:512-485-7200
Mailing Address - Fax:512-485-7220
Practice Address - Street 1:4100 DUVAL RD
Practice Address - Street 2:BLDG. 3, STE. 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3550
Practice Address - Country:US
Practice Address - Phone:512-485-7200
Practice Address - Fax:512-485-7220
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2016-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
1095561363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant