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General NPI Number Information
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NPI Number | 1649062563
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Entity Type | Individual
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Provider Name | LACY LYNETTE WILKINS
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Gender | Female
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 19298 W LAKE HOUSTON PKWY STE 240
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City | HUMBLE
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State | TX
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Zip | 77346-4827
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Country | US
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Telephone | 832-828-4990
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Fax |
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Provider Business Mailing Address
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Address Line | 3411 ACACIA GROVE LN
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City | SPRING
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State | TX
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Zip | 77386-5056
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Country | US
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Telephone | 713-824-2302
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1349272
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License Number State | TX
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