| NPI | 1518328616 |
|---|---|
| Former Name | LISA JO HOUSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: GA LDO002657) |
| Additional Taxonomies | 156FC0801X Technician/Technologist, Contact Lens Fitter (Licence: GA LDO002657) |
| 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: GA LDO002657) | |
| Enumeration Date | 2016-03-16 |
| Last Update Date | 2016-03-16 |