Provider Demographics
NPI:1710260922
Name:LAWHON, BRODY LYNN
Entity Type:Individual
Prefix:
First Name:BRODY
Middle Name:LYNN
Last Name:LAWHON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 COLLEGE PARK DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4099
Mailing Address - Country:US
Mailing Address - Phone:281-362-0006
Mailing Address - Fax:
Practice Address - Street 1:3101 COLLEGE PARK DR
Practice Address - Street 2:SUITE 106
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4099
Practice Address - Country:US
Practice Address - Phone:936-273-1095
Practice Address - Fax:936-273-1074
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1210918225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist