Ageless Abandon

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G5718 Issued in TX

Legal business name

AGELESS ABANDON

Practice address

103 Tamarac CT
Lakeway, TX 78734-4666

Phone

(512) 459-4400

NPI assigned

Jun 28, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Tracy M. Ganske

Title

Ceo

Phone

(512) 459-4400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309219200000",
    "number": "1992092951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W 9TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787034924",
            "telephone_number": "512-459-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 TAMARAC CT",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787344666",
            "telephone_number": "512-459-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS ABANDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A",
        "authorized_official_last_name": "GANSKE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-459-4400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "G5718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Achieve PT, PLLC
• Karen Alexandra Acosta, MD
• Madeline Adams, PT, DPT
• Shubha Adeni, M.D.
• Aderemi O Afonja
• Agilitas USA, Inc
• Irma Angelica Aguirre
• Andrea Ahern, RD, LD
• Faheem Ahmed, M.D.
• Taylor Aiken, DPT

• Obstetrics & Gynecology Physician in Lakeway, TX
• Providers in Lakeway, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.