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NPI Code Detail

MEDICARE: LEE T WILLIS MA LPC RN

MEDICARE: LEE T WILLIS MA LPC RN
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
1101YP1600XPastoral Counselor9496TX
2163W00000XRegistered Nurse421862TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
182228LOTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083717698
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE T WILLIS MA LPC RN
Provider Business Mailing Address
First Line : 401 BRANARD ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-5015
Country : US
Telephone Number : 713-529-0037
Fax Number : 713-526-4367
Provider Business Practice Location Address
First Line : 401 BRANARD ST
Second Line :
City : HOUSTON
State : TX
Zip : 77006-5015
Country : US
Telephone Number : 713-529-0037
Fax Number : 713-526-4367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2006
Last Update Date : 03/03/2009

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