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General NPI Number Information
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NPI Number | 1356003404
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Entity Type | Individual
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Provider Name | ASHLEY DENISE LANG
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Gender | Female
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 4714 FM 1488 RD STE 132
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City | CONROE
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State | TX
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Zip | 77384-4930
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Country | US
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Telephone | 972-366-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 6300 KELLY ELLIOTT RD
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City | ARLINGTON
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State | TX
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Zip | 76001-5128
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Country | US
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Telephone | 662-574-1133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1012220
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1012220
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License Number State | TX
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