| Lyon Healthcare Services Llc | |
|
525 N Sam Houston Pkwy E Ste 245 Houston TX 77060-4016 | |
| (832) 616-0698 | |
| (713) 513-5737 |
| Full Name | Lyon Healthcare Services Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 525 N Sam Houston Pkwy E Ste 245, Houston, Texas |
| Authorized Official Name and Position | Kamilah J Payne (OWNER) |
| Authorized Official Contact | 8326160698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lyon Healthcare Services Llc 15318 Aboyne Ln Humble TX 77346-4611 Ph: (832) 616-0698 | Lyon Healthcare Services Llc 525 N Sam Houston Pkwy E Ste 245 Houston TX 77060-4016 Ph: (832) 616-0698 |
| NPI Number | 1124614839 |
|---|---|
| Provider Enumeration Date | 12/16/2020 |
| Last Update Date | 02/15/2023 |
| Medicare PECOS PAC ID | 9830505940 |
|---|---|
| Medicare Enrollment ID | O20210315001222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124614839 | NPI | - | NPPES |
| 1417503624 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Kamilah Jewel Lyon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417503624 PECOS PAC ID: 0749696854 Enrollment ID: I20210315001291 |
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