Lacey Elizabeth Crochet
Physician Assistant in Lakeway, TX. Individual provider (NPI-1).
NPI number1255812947
StatusActive
Last updated in NPPESApr 6, 2021
Details
- NPI
- 1255812947
- Entity type
- Individual (NPI-1)
- Name
- Lacey Elizabeth Crochet
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 22, 2018
- Certification date
- Apr 6, 2021
- Last updated
- Apr 6, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA12562 | TX | Yes |
Practice location
200 Medical Pkwy Ste 110Lakeway, TX 78738-1792
Phone 512-654-0150
Mailing address
Po Box 844658Dallas, TX 75284-4658
Phone 254-724-2111
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 18 Physician Assistant providers in Lakeway · All 623 providers in Lakeway
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