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Organization
SOUR LAKE HEALTH & MEDICAL, PLLC
Active
Organization
SOUR LAKE HEALTH & MEDICAL, PLLC
Active
Other names
Sour Lake Health & Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LACEY GUEDRY MSN, APRN, FNP-C (OWNER)
(409) 287-4100
Entity
Organization
Contact information
Practice address
689 SIXTH STREET, SOUR LAKE, TX 77659-1870
(409) 287-4100
(409) 287-4105
Mailing address
PO BOX 429, SOUR LAKE, TX 77659-0429
(409) 287-4100
(409) 287-4105
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
712554
TX
Other
Enumeration date
01/20/2012
Last updated
03/27/2019
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