Provider Demographics
NPI:1649450693
Name:LACY, VERMON EARL (ADMINISTRATOR)
Entity type:Individual
Prefix:MR
First Name:VERMON
Middle Name:EARL
Last Name:LACY
Suffix:
Gender:M
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 HILLCROFT ST
Mailing Address - Street 2:STE502
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-3190
Mailing Address - Country:US
Mailing Address - Phone:713-774-4449
Mailing Address - Fax:713-774-4459
Practice Address - Street 1:6420 HILLCROFT ST
Practice Address - Street 2:STE502
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3190
Practice Address - Country:US
Practice Address - Phone:713-774-4449
Practice Address - Fax:713-774-4459
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health