Provider Demographics
NPI:1619044658
Name:LYNETTE HESLET PHD PC
Entity type:Organization
Organization Name:LYNETTE HESLET PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WESLED
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:956-994-9262
Mailing Address - Street 1:3700 N 10TH ST
Mailing Address - Street 2:STE 309
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501
Mailing Address - Country:US
Mailing Address - Phone:956-994-9262
Mailing Address - Fax:956-994-9261
Practice Address - Street 1:3700 N 10TH ST
Practice Address - Street 2:STE 309
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-994-9262
Practice Address - Fax:956-994-9261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX25600103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0079AJ5Medicare ID - Type Unspecified