Provider Demographics
NPI:1902584030
Name:MEDIC, LEJLA (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:LEJLA
Middle Name:
Last Name:MEDIC
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 BEE CAVES RD STE 211
Mailing Address - Street 2:
Mailing Address - City:ROLLINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5642
Mailing Address - Country:US
Mailing Address - Phone:512-270-1105
Mailing Address - Fax:
Practice Address - Street 1:2720 BEE CAVES RD STE 211
Practice Address - Street 2:
Practice Address - City:ROLLINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:78746-5642
Practice Address - Country:US
Practice Address - Phone:512-270-1105
Practice Address - Fax:512-631-0050
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1127869363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health