Individual
NICKOLONDRIA LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4250 COOK RD, HOUSTON, TX 77072-1115
(832) 563-7537
Mailing address
5118 LONE TREE DR, FULSHEAR, TX 77441-2206
(832) 563-7537
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
193792
TX
2255A2300X
Athletic Trainer
Primary
AT4754
TX
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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