Provider Demographics
NPI:1568973782
Name:JANSON, ELIZABETH LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LYNN
Last Name:JANSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LYNN
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:2905 SAN GABRIEL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3548
Mailing Address - Country:US
Mailing Address - Phone:512-815-0123
Mailing Address - Fax:512-861-6206
Practice Address - Street 1:2905 SAN GABRIEL ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3548
Practice Address - Country:US
Practice Address - Phone:512-815-0123
Practice Address - Fax:512-861-6206
Is Sole Proprietor?:No
Enumeration Date:2017-10-15
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical