Individual
HAILEY LANGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
900 W 38TH ST STE 400, AUSTIN, TX 78705-1141
(512) 206-3600
Mailing address
11204 CUSSETA LN, AUSTIN, TX 78739-2075
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA15080
TEXAS MEDICAL BOARD
TX
Enumeration date
11/09/2021
Last updated
12/14/2021
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