Organization · Type 2 NPI

Sour Lake Health & Medical, PLLC

Family Nurse Practitioner · Sour Lake, TX

NPI number 1346511433 Active

Practice location

689 Sixth Street
Sour Lake, TX 77659-1870

Call (409) 287-4100 Map

Fax (409) 287-4105

Mailing address

PO Box 429
Sour Lake, TX 77659-0429

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	712554 (TX)

Family Nurse Practitioner: Definition to come...

NPI record

NPI: 1346511433
Entity type: Organization (Type 2)
Issued: Jan 20, 2012
Last updated: Mar 27, 2019
Status: Active

Other names

<unavail>
Sour Lake Health & Medical · doing business as
Sour Lake Health & Medical · doing business as

Authorized official

Mrs. Lacey Guedry, MSN, APRN, FNP-C
Owner
(409) 287-4100

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1346511433

Sour Lake Health & Medical, PLLC's National Provider Identifier is 1346511433, issued on Jan 20, 2012. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Sour Lake, TX. The record was last updated on Mar 27, 2019.