NICOLE LACKOWSKI (NPI# 1356448781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356448781 |
| Entity Type | Individual |
| Full Name | NICOLE LACKOWSKI |
| Credential | P.A.-C |
| Practice Address |
100 West Dean Keeton Austin TX 78712 |
| Mailing Address |
Po Box 7339 Austin TX 78713-7339 |
| Practice Telephone | 5124756635 |
| Practice Fax Number | 5124710680 |
| Mailing Telephone | 5124756635 |
| Mailing Fax Number | 5124710680 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-03-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA02093 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
100 WEST DEAN KEETON |
| City | AUSTIN |
| State | TX |
| Zip Code | 78712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558320192 | Ginger Ann Bloomer | Family Medicine | 100 West Dean Keeton, Austin, TX 78712 | 2006-03-22 |
| 1194950600 | Jeffrey R Latimer | Internal Medicine | 100 West Dean Keeton, Austin, TX 78712 | 2009-05-28 |
| 1184700197 | Lucia Beth Waldrop | Nurse Practitioner | 100 West Dean Keeton, Austin, TX 78713-7339 | 2006-10-31 |
| 1841392347 | Karen Ann Hickey | Nurse Practitioner | 100 West Dean Keeton, Austin, TX 78712-1107 | 2006-09-04 |
| 1003852179 | Albert Edward Meisenbach IIi | Family Medicine | 100 West Dean Keeton, Austin, TX 78712 | 2006-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681887 | Sarah Mae Clifford | Specialist/Technologist | 405 E 23rd Street, Austin, TX 78712 | 2020-08-27 |
| 1013533603 | Caleb Montgomery Burleson | Specialist/Technologist | College of Education 1912 Speedway, Stop D5000, Austin, TX 78712 | 2020-06-19 |
| 1215550025 | Javier Benitez | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School General Surgery, 1500 Red River St., Austin, TX 78712 | 2020-05-27 |
| 1396382552 | H-e-b, Lp | Clinical Medical Laboratory | 1601 Trinity St Bldg A Ste 105, Austin, TX 78712 | 2019-12-06 |
| 1427693928 | The University of Texas At Austin | Psychologist | 100 W Dean Keeton St., Austin, TX 78712 | 2019-11-08 |
| 1013565803 | Chidinma Abengowe | Specialist/Technologist | 2015 San Jacinto Blvd, Austin, TX 78712 | 2019-08-27 |
| 1073010724 | Qaisar Alshebani | Internal Medicine | Ut Austin Dell Medical School, Dell Seton Medical Center 1500 Red River Rd, Austin, TX 78712 | 2018-04-10 |
| 1073066239 | The University of Texas At Austin | General Practice | 1601 Trinity Street, Austin, TX 78712 | 2016-07-25 |
| 1184081176 | Nahar Albudoor | Speech-Language Pathologist | 2504 A Whitis, Cma 2.200, A1100, University of Texas At Austin Speech & Hearing Center, Austin, TX 78712 | 2016-01-21 |
| 1922415181 | Kelly Marie Barker | Nurse Practitioner | 1601 Trinity St Ste 704f, Austin, TX 78712 | 2014-07-18 |
| Find all providers in zip 78712 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831704576 | Leila Olive Adell | Physician Assistant | 1221 S Congress Ave Apt 331, Austin, TX 78704-2461 | 2020-09-10 |
| 1740816982 | Alyssa Conrad | Physician Assistant | 4818 Star Jasmine Dr, Austin, TX 78723-6059 | 2020-03-19 |
| 1588207344 | Haley Margaret Roberts | Physician Assistant | 2200 Park Bend Dr Bldg 3-300, Austin, TX 78758-5386 | 2019-10-24 |
| 1073178901 | Ndukaku Dayton Ibe | Physician Assistant | 4411 Spicewood Springs Rd Apt 208, Austin, TX 78759-8570 | 2019-05-06 |
| 1285176172 | Leah Nichole Burandt | Physician Assistant | 2512 S Interstate 35 Ste 310, Austin, TX 78704 | 2016-11-09 |
| 1437607793 | Danielle Marie Werge | Physician Assistant | 6601 Vaught Ranch Rd, Suite 200, Austin, TX 78730-2307 | 2016-09-15 |
| 1831556158 | Kristin Serrano | Physician Assistant | 1524 S Interstate 35, Suite 202, Austin, TX 78704-8931 | 2016-01-16 |
| 1912309675 | Rachael Lichtenberger | Physician Assistant | 11609 Anderson Mill Rd, Austin, TX 78750-1354 | 2014-09-24 |
| 1417367707 | Sarah Caroline Moody Vance | Physician Assistant | 3000 N Interstate 35 Ste 600, Austin, TX 78705-1850 | 2014-05-07 |
| 1801165485 | Maegen Ricki Kennedy | Physician Assistant | 4107 South Captial Texas Hwy Suite 100a, Austin, TX 78704 | 2011-12-28 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.