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1275307472
LISA LARAINE SOUTH
HOUSTON, TX
NPI
1275307472
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: TX 1134088)
Enumeration Date
2023-11-08
Last Update Date
2024-09-26
Business Address
LISA LARAINE SOUTH NP
6720 BERTNER AVE
HOUSTON, TX 77030-2604
Phone number: 323-552-6668
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Mailing Address
LISA LARAINE SOUTH NP
9373 N WALKER RD
CLEVELAND, TX 77328-5835
Phone number: 832-797-9670
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