Provider Demographics
NPI:1437817848
Name:LACOMBE, ROSS
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:LACOMBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15808 W DORMAN DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-5469
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2050 DOUBLE CREEK DR STE 150
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2526
Practice Address - Country:US
Practice Address - Phone:512-230-3740
Practice Address - Fax:512-727-1343
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical