SOUR LAKE HEALTH & MEDICAL
NPI 1346511433
Nurse Practitioner - Family in Sour Lake, TX
About Sour Lake Health & Medical NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUR LAKE HEALTH & MEDICAL (NPI 1346511433) is a healthcare organization registered as a family in Sour Lake, Texas and active in the NPI registry since January 2012. The organization holds a CLIA Waiver certificate valid through May 6, 2028 and lists Lacey Guedry, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Sour Lake Health & Medical is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Sour Lake Health & Medical, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2040635
Sour Lake Health & Medical · Sour Lake, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sour Lake Health & Medical, PLLC's NPI number?
The NPI number for Sour Lake Health & Medical, PLLC is 1346511433. It was assigned to this organization in the NPPES registry on January 20, 2012. The provider is doing business as Sour Lake Health & Medical.
Where is Sour Lake Health & Medical, PLLC located?
Sour Lake Health & Medical, PLLC is located at 689 Sixth Street, Sour Lake, TX 77659. The listed phone number is (409) 287-4100.
What is Sour Lake Health & Medical, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Sour Lake Health & Medical, PLLC enrolled in Medicare?
Yes. Sour Lake Health & Medical, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sour Lake Health & Medical, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Sour Lake Health & Medical, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Sour Lake Health & Medical, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D2040635) is associated with this NPI, valid through May 6, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Sour Lake Health & Medical, PLLC was last updated on March 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sour Lake Health & Medical · NPI 1346511433
Family organization in Sour Lake, Texas. Organization record, active in the CMS NPPES registry since January 20, 2012.
## Identity
- **NPI:** 1346511433 (Entity type: Organization)
- **Enumerated:** January 20, 2012
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Sour Lake Health & Medical, Pllc
- **Organization subpart:** No
- **Authorized official:** Lacey Guedry, OWNER
## Practice location
- **Address:** 689 SIXTH STREET, Sour Lake, TX 77659-1870
- **Phone:** (409) 287-4100 · **Fax:** (409) 287-4105
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 27, 2019
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1346511433) · Data from the CMS NPPES public registry.