MEDICARE: MRS. LYNN ELLEN HUNGERFORD PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	23076	TX
2	103T00000X	Psychologist	6697	TX
3	103T00000X	Psychologist	2495	TX

General Provider Information

NPI Number	:	1003924184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNN ELLEN HUNGERFORD PHD

Provider Business Mailing Address
First Line	:	PO BOX 890382
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77289
Country	:	US
Telephone Number	:	281-218-7900
Fax Number	:	281-218-6601

Provider Business Practice Location Address
First Line	:	1300 BAY AREA BLVD BLDG B #125
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-2505
Country	:	US
Telephone Number	:	281-218-7900
Fax Number	:	281-218-6601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	10/27/2023

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Directions to “ MRS. LYNN ELLEN HUNGERFORD PHD” Practice Location

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