Provider Demographics
NPI:1427826155
Name:HOANG-EASON, LAN LINDA (PTA)
Entity type:Individual
Prefix:
First Name:LAN
Middle Name:LINDA
Last Name:HOANG-EASON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2431 CENTERLINE RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4307
Mailing Address - Country:US
Mailing Address - Phone:832-343-6242
Mailing Address - Fax:
Practice Address - Street 1:450 WOODLAND SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-2217
Practice Address - Country:US
Practice Address - Phone:832-343-6242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2134735225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant