Organization
LOTUS WELLNESS AND HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA LAYNE STOVALL (ADMINISTRATOR)
(512) 426-3514
Entity
Organization
Contact information
Practice address
3407 GLENVIEW AVE, AUSTIN, TX 78703-1448
(512) 716-0861
Mailing address
3407 GLENVIEW AVE, AUSTIN, TX 78703-1448
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
FIRST TIME APPLYING FOR NPI
—
Enumeration date
02/20/2018
Last updated
02/20/2018
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