Provider Demographics
NPI:1659145779
Name:BILLEAUDEAUX, ALYCIA TAYLOR (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALYCIA
Middle Name:TAYLOR
Last Name:BILLEAUDEAUX
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 ROUND VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-2259
Mailing Address - Country:US
Mailing Address - Phone:903-422-3239
Mailing Address - Fax:
Practice Address - Street 1:4910 MUELLER BLVD # 104
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:512-324-0042
Practice Address - Fax:512-342-0043
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1139831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily