Provider Demographics
NPI:1821691445
Name:LIGHTHOUSE BY P&C LLC
Entity Type:Organization
Organization Name:LIGHTHOUSE BY P&C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CYNISE
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:816-522-2528
Mailing Address - Street 1:5300 N BREASWOOD BLVD
Mailing Address - Street 2:STE 4, #5020
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4657
Mailing Address - Country:US
Mailing Address - Phone:832-654-6158
Mailing Address - Fax:
Practice Address - Street 1:5300 N BREASWOOD BLVD
Practice Address - Street 2:STE 4, #5020
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4657
Practice Address - Country:US
Practice Address - Phone:832-654-6158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty