LECELT INC NPI 1306372917

NPI Information

NPI: 1306372917
Provider Name: LECELT, INC

Doing Business As: HENRIKSON PRIMARY CARE

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
2133 OFFICE PARK DR STE A
SAN ANGELO, TX
ZIP 76904
Phone: (325) 703-6670
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LECELT, INC is a family nurse practitioner in San Angelo, TX. LECELT, INC NPI is 1306372917. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Henrikson Primary Care.

The provider's business location address is:

2133 OFFICE PARK DR STE A
SAN ANGELO, TX
ZIP 76904-803
Phone: (325) 703-6670
Fax: (325) 703-6672

The provider's authorized official is Jean Lynn Henrikson .
The authorized official title is Owner and has the following contact phone number (325) 703-6670.

The CLIA number assigned to this NPI record is 45D2133163 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/3/2017 and was last updated on 5/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family		TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	164744807	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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