Individual
LAUREN NICOLE SEDERHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4407 BEE CAVES RD STE 612, WEST LAKE HILLS, TX 78746-5285
(512) 446-9486
(512) 597-0402
Mailing address
PO BOX 889230, LOS ANGELES, CA 90088-9230
(512) 446-9486
(512) 597-0402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA07293
TX
363AS0400X
Surgical Physician Assistant
Primary
PA07293
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287558505
—
TX
Enumeration date
05/10/2011
Last updated
05/08/2024
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