Provider Demographics
NPI:1518034933
Name:WEST LPN INC
Entity Type:Organization
Organization Name:WEST LPN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-401-8726
Mailing Address - Street 1:3900 W 15TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7751
Mailing Address - Country:US
Mailing Address - Phone:972-519-8300
Mailing Address - Fax:972-519-8337
Practice Address - Street 1:3900 W 15TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7751
Practice Address - Country:US
Practice Address - Phone:972-519-8300
Practice Address - Fax:972-519-8337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176917604Medicaid
TX176917601Medicaid
TX176917603Medicaid
TX00023ZMedicare PIN
TX176917601Medicaid
TXP00438906Medicare PIN