Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 568063 | TX |
NPI | 1093871543 |
---|---|
Provider Name | Glenda R. Lemons |
First Address | Dallas, TX 75266-0599 |
Second Address | Dallas, TX 75235-7708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 27/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144842501 | (05) | TX |
144842502 | (05) | TX |
144842503 | (05) | TX |
144842504 | (05) | TX |
144842505 | (05) | TX |
144842506 | (05) | TX |
144842507 | (05) | TX |
144842508 | (05) | TX |
144842509 | (05) | TX |
144842510 | (05) | TX |
144842511 | (05) | TX |
S81403 | (02) |