Provider Demographics
NPI:1689341695
Name:GATLIN, LAWANDA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LAWANDA
Middle Name:
Last Name:GATLIN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4322 TIDEWATER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-4342
Mailing Address - Country:US
Mailing Address - Phone:832-723-0139
Mailing Address - Fax:
Practice Address - Street 1:8703 MEADOWCROFT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5006
Practice Address - Country:US
Practice Address - Phone:713-840-7956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1029706363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health