Provider Demographics
NPI:1750703096
Name:GUIDING LYTE FAMILY PRACTICE
Entity type:Organization
Organization Name:GUIDING LYTE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:832-286-5030
Mailing Address - Street 1:8191 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1709
Mailing Address - Country:US
Mailing Address - Phone:832-538-0871
Mailing Address - Fax:832-538-0877
Practice Address - Street 1:8191 SOUTHWEST FWY
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1709
Practice Address - Country:US
Practice Address - Phone:832-538-0871
Practice Address - Fax:832-538-0877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652807363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1609206697OtherINDIVIDUAL ZHEALTHCARE PROVIDER