1255836169 NPI number — MS. TYLER ALEXIUS LANGE LPC-S

Table of content: MS. TYLER ALEXIUS LANGE LPC-S (NPI 1255836169)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255836169 NPI number — MS. TYLER ALEXIUS LANGE LPC-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANGE
Provider First Name:
TYLER
Provider Middle Name:
ALEXIUS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC-S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255836169
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 W TEXAS AVE APT 613
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEBSTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77598-3263
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-285-6096
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6500 ROOKIN ST STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77074-5019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-351-7350
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 88494 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YS0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009352933 . This is a "HUMANA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 009352933 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 48638672 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 48638672 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009352933 . This is a "AETNA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 009352933 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 009352933 . This is a "CIGNA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".