Individual provider · Type 1 NPI

Audrey C. Lively, PA-C

Surgical Physician Assistant · Houston, TX

NPI number 1396027306 Active

Practice location

6414 Fannin St Ste G150
Houston, TX 77030-1514

Mailing address

6400 Fannin St Ste 1700
Houston, TX 77030-1526

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA07450 (TX)

Surgical Physician Assistant: Definition to come...

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About NPI 1396027306

Audrey C. Lively, PA-C's National Provider Identifier is 1396027306, issued on Sep 15, 2011. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Houston, TX. The record was last updated on Oct 22, 2018.