Individual provider Active NPI

Lacey L Flick, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1417257171
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
86162 Issued in TX
Practice address
1635 North Loop W
Houston, TX 77008-1532
Phone
(713) 400-2990
Fax
(713) 400-2993
NPI assigned
Oct 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 86162 TX Primary
Nurse Practitioner 363L00000X AP119855 TX
Registered Nurse 163W00000X RN723835 TX
Certified Registered Nurse Anesthetist 367500000X 723835 TX

Addresses

Primary practice location

1635 North Loop W
Houston, TX 77008-1532

Mailing address

PO Box 22926
Jackson, MS 39225-2926
Phone (713) 400-2990

Other identifiers 2

IdentifierTypeStateIssuer
723835OtherTXRN LICENSE
280605102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110511000710 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991981789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texans Anesthesia Associates PLLCGroup PAC ID 8820171390, 197 clinicians

Practice addresses (Care Compare)

1313 Hermann Dr
Houston, TX 77004-7005
Phone (713) 527-5000

1635 N Loop W
Houston, TX 77008-1532
Phone (713) 400-2990

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN723835TXMDRegistered Nurse
723835TXMDCertified Registered Nurse Anesthetist
86162TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Texans Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince May 14, 2017 Accepting new patients

Locations

1313 Hermann Dr
Houston, TX 77004
Phone (713) 527-5000

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

1313 Hermann Dr
Ste 270
Houston, TX 77004
Phone (281) 444-3681

7700 Fannin St
Houston, TX 77054
Phone (713) 790-1349

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1417257171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22926",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392252926",
            "telephone_number": "713-400-2990",
            "fax_number": "713-400-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 NORTH LOOP W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081532",
            "telephone_number": "713-400-2990",
            "fax_number": "713-400-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICK",
        "first_name": "LACEY",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-28",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "86162",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP119855",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "RN723835",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "723835",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "723835",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280605102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.