Provider Demographics
NPI:1306224506
Name:JOY, LATHA
Entity Type:Individual
Prefix:MRS
First Name:LATHA
Middle Name:
Last Name:JOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 LAKEWIND LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5795
Mailing Address - Country:US
Mailing Address - Phone:281-785-6504
Mailing Address - Fax:
Practice Address - Street 1:9504 LONG POINT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-4226
Practice Address - Country:US
Practice Address - Phone:713-461-3535
Practice Address - Fax:713-461-3518
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127895363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner