Provider Demographics
NPI:1720763121
Name:LI, ADA (CAA)
Entity Type:Individual
Prefix:
First Name:ADA
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:CAA
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Mailing Address - Street 1:11200 PRAIRIE DOVE CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4251
Mailing Address - Country:US
Mailing Address - Phone:813-766-1277
Mailing Address - Fax:
Practice Address - Street 1:919 E 32ND ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2703
Practice Address - Country:US
Practice Address - Phone:512-544-7111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-11-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant