Provider Demographics
NPI:1538153945
Name:LYON, KAREN CARTER (PHD RN CNS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:CARTER
Last Name:LYON
Suffix:
Gender:F
Credentials:PHD RN CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4006 MRSNY CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2072
Mailing Address - Country:US
Mailing Address - Phone:713-794-2882
Mailing Address - Fax:713-794-2103
Practice Address - Street 1:605 HOLDERRIETH BLVD
Practice Address - Street 2:WOUND CENTER
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6445
Practice Address - Country:US
Practice Address - Phone:281-401-7943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX232773364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089369501Medicaid
NMQ3561Medicaid
TXCN0024Medicare ID - Type Unspecified
S47665Medicare UPIN
NM331417405Medicare ID - Type Unspecified