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Organization

PROLIXANT THERAPEUTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HEATHER A EVANS (PRESIDENT)
(512) 804-8890
Entity
Organization

Contact information

Practice address
6205B BURNET RD, AUSTIN, TX 78757-3227
(512) 772-1225
(512) 772-1227
Mailing address
6205B BURNET RD, AUSTIN, TX 78757-3227
(512) 772-1225
(512) 772-1227

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
207N00000X
Dermatology Physician
207R00000X
Internal Medicine Physician
207RI0200X
Infectious Disease Physician
207RP1001X
Pulmonary Disease Physician
208200000X
Plastic Surgery Physician
Primary
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
2086S0122X
Plastic and Reconstructive Surgery Physician
208D00000X
General Practice Physician
213E00000X
Podiatrist
225100000X
Physical Therapist
246RP1900X
Phlebotomy Technician
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
02/21/2019
Last updated
07/15/2024
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