Provider Demographics
NPI:1609185644
Name:LYONS, JENNIFER CROUCH (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CROUCH
Last Name:LYONS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 PINE BLOSSOM CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2104
Mailing Address - Country:US
Mailing Address - Phone:979-571-7952
Mailing Address - Fax:
Practice Address - Street 1:2310 PINE BLOSSOM CT
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-2104
Practice Address - Country:US
Practice Address - Phone:979-571-7952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1137529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist