Provider Demographics
NPI:1669925491
Name:LYONS CENTER FOR FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:LYONS CENTER FOR FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-453-6351
Mailing Address - Street 1:310 FREEPORT ST STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-2339
Mailing Address - Country:US
Mailing Address - Phone:713-453-6351
Mailing Address - Fax:713-453-7322
Practice Address - Street 1:310 FREEPORT ST STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015
Practice Address - Country:US
Practice Address - Phone:713-453-6351
Practice Address - Fax:713-453-7322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX444134363LF0000X
TXJ4316207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty