OrganizationActive
Ageless Abandon
NPI 1992092951 · Obstetrics & Gynecology Physician · Lakeway, TX
Provider details
- NPI number
- 1992092951
- Entity type
- Organization
- Primary specialty
- Obstetrics & Gynecology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tracy Ganske, Ceo(512) 459-4400
- License
- G5718 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
103 Tamarac Ct
Lakeway, TX 78734-4666
Phone: (512) 459-4400
Approximate (ZIP-level) locationGet directions
Mailing address
1010 W 9th St
Austin, TX 78703-4924
Registry dates
- Enumerated
- 2011-06-28
- Last updated
- 2011-06-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.