Nicole Leigh Vondall, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA07531 Issued in TX

Practice address

11300 N Lamar Blvd
Austin, TX 78753-2665

Phone

(512) 835-6751

NPI assigned

Dec 8, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Nicole Wheeler Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1780913574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787532665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787532665",
            "telephone_number": "512-835-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONDALL",
        "first_name": "NICOLE",
        "middle_name": "LEIGH",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-08",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "1090664",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WHEELER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lance Von Bracht, MD
• Rachael Jean Von Eschenbach, M.S. CCC-SLP
• Matthew William Von Holst, BCBA
• Kellen Von Houser, LPC
• Von'S in Home Care , LLC
• Mackenzie Vondrak, DPT
• Michelle Voneida, FNP
• Linda Davis Vonkreisler, RN CS
• Mary E Vono, M.D.
• Frank Volker Vonsehrwald, RPH

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.