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NPI Code Detail

MEDICARE: LASHAWNDA LATIKI GRAY LVN

MEDICARE:   LASHAWNDA LATIKI GRAY  LVN
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
1164X00000XLicensed Vocational Nurse310081TX

General Provider Information

NPI Number : 1619598711
Entity Type Code : Individual
Provider Name (Legal Business Name) : LASHAWNDA LATIKI GRAY LVN
Provider Business Mailing Address
First Line : 2834 FOX MOUNTAIN DR
Second Line :
City : SPRING
State : TX
Zip : 77386-2391
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2834 FOX MOUNTAIN DR
Second Line :
City : SPRING
State : TX
Zip : 77386-2391
Country : US
Telephone Number : 832-794-3223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2020
Last Update Date : 04/29/2020

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Directions to “ LASHAWNDA LATIKI GRAY LVN” Practice Location

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