Provider Demographics
NPI:1972685113
Name:HENRY, LUCINDA MONICA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LUCINDA
Middle Name:MONICA
Last Name:HENRY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:207 THAT WAY ST STE A-1
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5211
Mailing Address - Country:US
Mailing Address - Phone:979-297-7337
Mailing Address - Fax:979-266-9076
Practice Address - Street 1:210 LAKE RD STE 600
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4982
Practice Address - Country:US
Practice Address - Phone:979-297-7337
Practice Address - Fax:979-266-9076
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical