Provider Demographics
NPI:1992099451
Name:MALLETT, ALECIA WALKER (RN, NP-C)
Entity type:Individual
Prefix:
First Name:ALECIA
Middle Name:WALKER
Last Name:MALLETT
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-0047
Mailing Address - Country:US
Mailing Address - Phone:281-351-5922
Mailing Address - Fax:
Practice Address - Street 1:720 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-0047
Practice Address - Country:US
Practice Address - Phone:281-351-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX510402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily