Provider Demographics
NPI:1104443944
Name:FREEMAN, NELSON LASANA
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:LASANA
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 HAYES RD APT 232
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6634
Mailing Address - Country:US
Mailing Address - Phone:832-754-0216
Mailing Address - Fax:
Practice Address - Street 1:2828 HAYES RD APT 232
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6634
Practice Address - Country:US
Practice Address - Phone:832-754-0216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-27
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist