Provider Demographics
NPI:1043648017
Name:AMES, LOIS E (NP)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:E
Last Name:AMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14420 SHOREDALE LN
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2050
Mailing Address - Country:US
Mailing Address - Phone:469-644-7818
Mailing Address - Fax:
Practice Address - Street 1:14420 SHOREDALE LN
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-2050
Practice Address - Country:US
Practice Address - Phone:469-644-7818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX457549163WM0705X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000572OtherNO IDENTIFIERS CURRENTLY IN USE