Provider Demographics
NPI:1558079533
Name:DOLLAHITE, ALICIA MARIA (APRN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIA
Last Name:DOLLAHITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7112 ED BLUESTEIN BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2913
Mailing Address - Country:US
Mailing Address - Phone:512-744-6000
Mailing Address - Fax:
Practice Address - Street 1:7112 ED BLUESTEIN BLVD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2913
Practice Address - Country:US
Practice Address - Phone:512-744-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1088158363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics