Lakeside Mental Health PLLC
Nurse Practitioner, Psych/Mental Health in Conroe, TX. Organization (NPI-2).
NPI number1801551981
StatusActive
Last updated in NPPESNov 3, 2021
Details
- NPI
- 1801551981
- Entity type
- Organization (NPI-2)
- Legal business name
- Lakeside Mental Health PLLC
- Organization subpart
- No
- Enumeration date
- Nov 3, 2021
- Certification date
- Nov 3, 2021
- Last updated
- Nov 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
96 Beach Walk Blvd Ste 208Conroe, TX 77304-4549
Phone 281-393-4692
Mailing address
96 Beach Walk Blvd Ste 208Conroe, TX 77304-4549
Phone 281-393-4692
Authorized official
Michael Graves
Owner
2813934692
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