Individual
ASHLYN ARCHER FREDERIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11714 WILSON PARKE AVE STE 150, AUSTIN, TX 78726-4061
(737) 247-7200
(512) 406-7368
Mailing address
6210 E HWY 290, AUSTIN, TX 78723-1098
(512) 483-9596
(512) 406-7621
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA16175
TX
363A00000X
Physician Assistant
Primary
PA16175
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/19/2020
Last updated
06/12/2026
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