Provider Demographics
NPI:1598350654
Name:LIGHTSEY, LILLIE ANN (BS)
Entity Type:Individual
Prefix:
First Name:LILLIE
Middle Name:ANN
Last Name:LIGHTSEY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15222 HEMINGWAY HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-2702
Mailing Address - Country:US
Mailing Address - Phone:832-732-5169
Mailing Address - Fax:
Practice Address - Street 1:15222 HEMINGWAY HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77302-2702
Practice Address - Country:US
Practice Address - Phone:832-732-5169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic