Lido Senior Club LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

LIDO SENIOR CLUB LLC

Practice address

12800 Veterans Memorial Dr
Houston, TX 77014-2004

Phone

(917) 445-7201

Fax

(281) 858-2070

NPI assigned

May 8, 2020

Organization subpart

No

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

Authorized official

Name

Donald Dam Le

Title

Director

Phone

(917) 445-7201

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1588896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588896000000",
    "number": "1881216232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11703 GALLANT RIDGE LANE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770826832",
            "telephone_number": "917-445-7201",
            "fax_number": "281-858-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 VETERANS MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770142004",
            "telephone_number": "917-445-7201",
            "fax_number": "281-858-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIDO SENIOR CLUB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-08",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "DAM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "917-445-7201"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Licon
• Ana Licona, APRN, FNP-C
• Genesis Licona, MD
• Liddell Family Healthcare
• Miracle Liddell, MA
• Biviana Lie, OD
• Jessica Jin Lie, MD
• Eula Marie Lieber, CRNA
• Michael W Lieberman, MD PHD
• Michael Garry Liebl, PHARMD

• Adult Day Care Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.