Provider Demographics
NPI:1851114730
Name:MAWDSLEY, CHRISTY LEE (LAC)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:LEE
Last Name:MAWDSLEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 MILAN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3775
Mailing Address - Country:US
Mailing Address - Phone:520-591-6747
Mailing Address - Fax:
Practice Address - Street 1:201 S LAKELINE BLVD STE 403
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2735
Practice Address - Country:US
Practice Address - Phone:520-591-6747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC02159171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty