Provider Demographics
NPI:1427312503
Name:MCDANIEL, LOIS JOYCE (NP)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:JOYCE
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12094 LAKE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77318-5232
Mailing Address - Country:US
Mailing Address - Phone:936-856-6617
Mailing Address - Fax:
Practice Address - Street 1:25110 GROGANS MILL RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2248
Practice Address - Country:US
Practice Address - Phone:281-367-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX537583363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily