Provider Demographics
NPI:1881706224
Name:EASELY, LAMON DONELL JR
Entity type:Individual
Prefix:MR
First Name:LAMON
Middle Name:DONELL
Last Name:EASELY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 N SAM HOUSTON PKWY E
Mailing Address - Street 2:STE 611
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-3276
Mailing Address - Country:US
Mailing Address - Phone:281-359-2273
Mailing Address - Fax:
Practice Address - Street 1:6000 N SAM HOUSTON PKWY E
Practice Address - Street 2:STE 611
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-3276
Practice Address - Country:US
Practice Address - Phone:281-359-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0084628171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor