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General NPI Number Information
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NPI Number | 1740882174
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Entity Type | Individual
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Provider Name | KEVIN LASSEN
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Gender | Male
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 26270 NORTHWEST FWY
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City | CYPRESS
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State | TX
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Zip | 77429-1761
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Country | US
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Telephone | 281-304-9664
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Fax | 281-304-0803
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Provider Business Mailing Address
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Address Line | 31110 DURHAM CREEK CT
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City | TOMBALL
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State | TX
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Zip | 77375-1646
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Country | US
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Telephone | 832-969-0856
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 33716
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License Number State | TX
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