Individual
LINDA LEE DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2501 JIMMY JOHNSON BLVD., SUITE 405, PORT ARTHUR, TX 77640
(409) 722-6553
Mailing address
3746 CHAMPIONS DR, BEAUMONT, TX 77707-5471
(409) 840-6942
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
681827
TX
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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