Healthcare Provider Details

I. General information

NPI: 1205144524
Provider Name (Legal Business Name): LASSETTER HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10627 TWILIGHT CREEK LN
CYPRESS TX
77433-3527
US

IV. Provider business mailing address

10627 TWILIGHT CREEK LN
CYPRESS TX
77433-3527
US

V. Phone/Fax

Practice location:
  • Phone: 832-603-7188
  • Fax:
Mailing address:
  • Phone: 832-603-7188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number630139
License Number StateTX

VIII. Authorized Official

Name: MELISSA JEAN LASSETTER
Title or Position: OWNER
Credential: RN
Phone: 832-603-7188