Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Brooke Marie Stidham, PAC

Individual provider Physician Assistant · NPI 1134450497

Mrs. Brooke Marie Stidham, PAC is a Physician Assistant in Austin, Texas. Qualified in 2007, 19 years ago. Practices with Ladera Park Dermatology PA, a 3-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
19
Licensed in
TX
In the registry since
2010
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

11623 Angus Rd Ste 25
Austin, TX 78759-4003
Phone: (512) 345-9411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA08059 (TX)

Record details

NPI number1134450497
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedJanuary 26, 2010
Last updated in NPPESMarch 20, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Ladera Park Dermatology Pa — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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