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NPI Code Detail

MEDICARE: LIXIAN LUO AGACNP, PMHNP

MEDICARE: LIXIAN LUO AGACNP, PMHNP
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
1363LA2100XAcute Care Nurse Practitioner700675TX
2363LP0808XPsychiatric/Mental Health Nurse Practitioner700675TX

General Provider Information

NPI Number : 1144651928
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIXIAN LUO AGACNP, PMHNP
Provider Business Mailing Address
First Line : 3002 DAVEY OAKS ST
Second Line :
City : PEARLAND
State : TX
Zip : 77584-7654
Country : US
Telephone Number : 713-419-1316
Fax Number : 281-997-7620
Provider Business Practice Location Address
First Line : 6565 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2703
Country : US
Telephone Number : 713-441-2569
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2013
Last Update Date : 08/07/2025

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