Provider Demographics
NPI:1932373123
Name:TRANQUIL TRANSITIONS
Entity Type:Organization
Organization Name:TRANQUIL TRANSITIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:OSBORNE
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:512-751-0753
Mailing Address - Street 1:8408 TYHURST DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-3522
Mailing Address - Country:US
Mailing Address - Phone:512-751-0753
Mailing Address - Fax:
Practice Address - Street 1:3201 HIGHWAY 71 E
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-5126
Practice Address - Country:US
Practice Address - Phone:512-321-8269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX518261367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty