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Individual

MRS. LACEY LYNN MCCLURE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
110 E MEDICAL CENTER BLVD, WEBSTER, TX 77598-4301
(832) 224-9500
Mailing address
18333 EGRET BAY BLVD STE 140, HOUSTON, TX 77058-3239
(281) 332-3001
(281) 332-3005

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1029696
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
424368501
TX
05
424368502
TX
01
8PW475
BCBS
TX
Enumeration date
02/11/2021
Last updated
12/13/2023
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