Provider Demographics
NPI:1063993665
Name:VINCENT, LILIAN (NURSE RN)
Entity type:Individual
Prefix:
First Name:LILIAN
Middle Name:
Last Name:VINCENT
Suffix:
Gender:F
Credentials:NURSE RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21438 RIVER COURT DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-6028
Mailing Address - Country:US
Mailing Address - Phone:281-460-2256
Mailing Address - Fax:
Practice Address - Street 1:16320 MELLOW OAKS LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7214
Practice Address - Country:US
Practice Address - Phone:281-460-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX799790163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse