Provider Demographics
NPI:1972282648
Name:EBRAHIMI, LALEH (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:LALEH
Middle Name:
Last Name:EBRAHIMI
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12615 BETHANY BAY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7867
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12615 BETHANY BAY DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7867
Practice Address - Country:US
Practice Address - Phone:832-863-5978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2025-06-17
Deactivation Date:2025-01-07
Deactivation Code:
Reactivation Date:2025-06-17
Provider Licenses
StateLicense IDTaxonomies
TXAP127238363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily