Individual
KEREN AVIV STICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
300 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/25/2017
Last updated
03/28/2024
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