MEDICARE: KEVIN LENE NP

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	363LF0000X	Family Nurse Practitioner	AP133131	TX

General Provider Information

NPI Number	:	1831639814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN LENE NP

Provider Business Mailing Address
First Line	:	1714 GUNWALE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-4540
Country	:	US
Telephone Number	:	281-989-1683
Fax Number	:

Provider Business Practice Location Address
First Line	:	9809 ROWLETT RD # A
Second Line	:	SUITE A-1
City	:	HOUSTON
State	:	TX
Zip	:	77075-3403
Country	:	US
Telephone Number	:	713-644-1119
Fax Number	:	713-644-0900

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

Provider Enumeration Date	:	02/24/2017
Last Update Date	:	02/24/2017

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Directions to “ KEVIN LENE NP” Practice Location

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