Provider Demographics
NPI:1780238857
Name:DAMRON, LILIANA (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:DAMRON
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:LILIANA
Other - Middle Name:
Other - Last Name:EUFRACIO LUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5604 SOUTHWEST PKWY APT 514
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6245
Mailing Address - Country:US
Mailing Address - Phone:936-240-7892
Mailing Address - Fax:
Practice Address - Street 1:1108 LAVACA ST STE 110-320
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2172
Practice Address - Country:US
Practice Address - Phone:512-477-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-27
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142457363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty