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General NPI Number Information
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NPI Number | 1669925491
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Entity Type | Organization
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Legal Business Name | LYONS CENTER FOR FAMILY MEDICINE PLLC
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Dates
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Enumeration Date | 07/28/2016
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Last Update Date | 07/29/2016
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Provider Practice Location Address
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Address Line | 310 FREEPORT ST STE A
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City | HOUSTON
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State | TX
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Zip | 77015
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Country | US
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Telephone | 713-453-6351
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Fax | 713-453-7322
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Provider Business Mailing Address
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Address Line | 310 FREEPORT ST STE A
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City | HOUSTON
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State | TX
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Zip | 77015-2339
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Country | US
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Telephone | 713-453-6351
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Fax | 713-453-7322
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHAEL J LYONS
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Credential | D.O.
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Telephone | 713-453-6351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 444134
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License Number State | TX
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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 | J4316
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License Number State | TX
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