| L & A Professional Services, Llc | |
|
17240 Huffmeister Rd Ste 104 Cypress TX 77429-4694 | |
| (832) 683-4275 | |
| (832) 683-4267 |
| Full Name | L & A Professional Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 17240 Huffmeister Rd Ste 104, Cypress, Texas |
| Authorized Official Name and Position | Lisa A Wines (CEO) |
| Authorized Official Contact | 8326834275 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| L & A Professional Services, Llc Po Box 2453 Cypress TX 77410-2453 Ph: (832) 683-4275 | L & A Professional Services, Llc 17240 Huffmeister Rd Ste 104 Cypress TX 77429-4694 Ph: (832) 683-4275 |
| NPI Number | 1518459205 |
|---|---|
| Provider Enumeration Date | 05/30/2018 |
| Last Update Date | 05/30/2018 |
| Medicare PECOS PAC ID | 9436691235 |
|---|---|
| Medicare Enrollment ID | O20240607002880 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518459205 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 69929 (Texas) | Primary |
| Provider Name | Lisa Ann Wines |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780039107 PECOS PAC ID: 0345782140 Enrollment ID: I20240607003094 |
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