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General NPI Number Information
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NPI Number | 1124614839
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Entity Type | Organization
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Legal Business Name | LYON HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 16510 NORTHCHASE DR STE 254
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City | HOUSTON
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State | TX
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Zip | 77060-3302
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Country | US
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Telephone | 346-442-6856
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Fax | 281-595-9823
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Provider Business Mailing Address
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Address Line | 15318 ABOYNE LN
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City | HUMBLE
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State | TX
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Zip | 77346-4611
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Country | US
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Telephone | 346-442-6856
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAMILAH J PAYNE
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Credential | FNP-C
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Telephone | 346-442-6856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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