Provider Demographics
NPI:1700970449
Name:LASK, ELIZABETH MARY (NP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MARY
Last Name:LASK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 MYSTIC SHORES BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-5033
Mailing Address - Country:US
Mailing Address - Phone:661-886-0042
Mailing Address - Fax:
Practice Address - Street 1:312 FM 306 STE 108
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-0301
Practice Address - Country:US
Practice Address - Phone:830-302-4260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1187653363L00000X
CANP7029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily