Provider Demographics
NPI:1144651928
Name:LUO, LIXIAN (AGACNP)
Entity type:Individual
Prefix:
First Name:LIXIAN
Middle Name:
Last Name:LUO
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3002 DAVEY OAKS ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7654
Mailing Address - Country:US
Mailing Address - Phone:713-419-1316
Mailing Address - Fax:281-997-7620
Practice Address - Street 1:2104 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3676
Practice Address - Country:US
Practice Address - Phone:832-594-4052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX700675363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care