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1396385662
MARK LIDASAN
MISSOURI CITY, TX
NPI
1396385662
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: TX 144499)
Enumeration Date
2020-01-14
Last Update Date
2020-02-10
Business Address
MARK LIDASAN
4502 RIVERSTONE BLVD STE 601
MISSOURI CITY, TX 77459-5205
Phone number: 281-778-9530
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Mailing Address
MARK LIDASAN
4502 RIVERSTONE BLVD STE 601
MISSOURI CITY, TX 77459-5205
Phone number: 281-778-9530
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