Individual
EDWARD DWAYNE LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
8807 LACY WILLOW CT, TOMBALL, TX 77375-2713
(832) 919-1509
Mailing address
8807 LACY WILLOW CT, TOMBALL, TX 77375-2713
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
328066
TX
Other
Enumeration date
07/19/2017
Last updated
08/24/2017
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