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NPI Code Detail

MEDICARE: LAKESHIA HENDERSON

MEDICARE: LAKESHIA HENDERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAP128675TX

General Provider Information

NPI Number : 1043605124
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAKESHIA HENDERSON
Provider Business Mailing Address
First Line : 1003 RICHMOND AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77006-5419
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1003 RICHMOND AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77006-5419
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2015
Last Update Date : 01/08/2017

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Directions to “ LAKESHIA HENDERSON ” Practice Location

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