MEDICARE: LYNETTE SCOTT AGPCNP-C

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
1	363LG0600X	Gerontology Nurse Practitioner	AG11200097	TX
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	AG11200097	TX

General Provider Information

NPI Number	:	1174113112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNETTE SCOTT AGPCNP-C

Provider Business Mailing Address
First Line	:	24200 SOUTHWEST FWY STE 402-107
Second Line	:
City	:	ROSENBERG
State	:	TX
Zip	:	77471-5984
Country	:	US
Telephone Number	:	832-582-0298
Fax Number	:	346-857-0298

Provider Business Practice Location Address
First Line	:	24285 KATY FWY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-1165
Country	:	US
Telephone Number	:	346-387-7171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2021
Last Update Date	:	02/03/2026

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