Provider Demographics
NPI:1831680040
Name:LAGRONE, CARMEN FLOY
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:FLOY
Last Name:LAGRONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 MCKINNEY FALLS PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-8401
Mailing Address - Country:US
Mailing Address - Phone:512-783-1247
Mailing Address - Fax:
Practice Address - Street 1:6901 MCKINNEY FALLS PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-8401
Practice Address - Country:US
Practice Address - Phone:512-783-1247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNA00657001364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist