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General NPI Number Information
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NPI Number | 1316648728
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Entity Type | Organization
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Legal Business Name | LYNX BEHAVIORAL HEALTH, PLLC
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 480 N SAM HOUSTON PKWY E # 380B
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City | HOUSTON
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State | TX
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Zip | 77060-3550
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Country | US
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Telephone | 346-604-4780
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Fax | 346-299-5190
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Provider Business Mailing Address
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Address Line | PO BOX 667603
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City | HOUSTON
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State | TX
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Zip | 77266-7603
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Country | US
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Telephone | 713-498-2112
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Fax | 346-299-5190
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Authorized Official
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Title or Position | PRINCIPAL
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Name | DERIC OUTLEY
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Credential | RN
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Telephone | 713-498-2112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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