Provider Demographics
NPI:1447444245
Name:LANIER, CASSANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:LANIER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 SAN GABRIEL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3548
Mailing Address - Country:US
Mailing Address - Phone:512-815-0123
Mailing Address - Fax:512-861-6206
Practice Address - Street 1:2905 SAN GABRIEL ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3548
Practice Address - Country:US
Practice Address - Phone:512-815-0123
Practice Address - Fax:512-861-6206
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10273208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery