Healthcare Provider Details

I. General information

NPI: 1104504737
Provider Name (Legal Business Name): LALA DANIEL GEORGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2023
Last Update Date: 04/05/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 DIMMITT RD STE 400
PLAINVIEW TX
79072-1833
US

IV. Provider business mailing address

2601 DIMMITT RD STE 400
PLAINVIEW TX
79072-1833
US

V. Phone/Fax

Practice location:
  • Phone: 806-296-9191
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number865061
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1113512
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: