Provider Demographics
NPI:1881175537
Name:GREENHOUSE, LAJIA D (LVN)
Entity type:Individual
Prefix:
First Name:LAJIA
Middle Name:D
Last Name:GREENHOUSE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1880
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77328-1880
Mailing Address - Country:US
Mailing Address - Phone:832-306-9166
Mailing Address - Fax:
Practice Address - Street 1:110 CYPRESS STATION DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1630
Practice Address - Country:US
Practice Address - Phone:832-253-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169605164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169605OtherLVN LICENSE
TX16931084OtherDRIVERS LICENSE