MEDICARE: LYNK WELL SPRING SERVICES PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	103T00000X	Psychologist
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1134726060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNK WELL SPRING SERVICES PLLC

Provider Business Mailing Address
First Line	:	10819 ASHLAND BRIDGE LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-5045
Country	:	US
Telephone Number	:	281-415-3127
Fax Number	:

Provider Business Practice Location Address
First Line	:	2424 W HOLCOMBE BLVD STE 204
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1935
Country	:	US
Telephone Number	:	832-280-6359
Fax Number	:	832-581-4309

Authorized Official
Title or Position	:	NP
Name	:	MRS. LILIAN IKE
Credential	:	ARNP
Telephone Number	:	281-415-3127

Provider Enumeration Date	:	10/04/2020
Last Update Date	:	05/14/2021

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