Provider Demographics
NPI:1174925218
Name:LAVALAIS, TYECHIA RENEE (FNP)
Entity type:Individual
Prefix:
First Name:TYECHIA
Middle Name:RENEE
Last Name:LAVALAIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TYECHIA
Other - Middle Name:RENEE
Other - Last Name:CAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST
Mailing Address - Street 2:SUITE 1700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1521
Mailing Address - Country:US
Mailing Address - Phone:713-486-1850
Mailing Address - Fax:713-512-7240
Practice Address - Street 1:6400 FANNIN ST
Practice Address - Street 2:SUITE 1700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1521
Practice Address - Country:US
Practice Address - Phone:713-486-1850
Practice Address - Fax:713-512-7240
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily