=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427312503
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LOIS JOYCE MCDANIEL NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/03/2012
-----------------------------------------------------
Last Update Date | 07/03/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25110 GROGANS MILL RD
-----------------------------------------------------
City | SPRING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-2248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-367-2290
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12094 LAKE VISTA DR
-----------------------------------------------------
City | WILLIS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77318-5232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-856-6617
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 537583
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------