Provider Demographics
NPI:1033436027
Name:CROWDUS, LISA C (REGISTERED PHARMACIS)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:C
Last Name:CROWDUS
Suffix:
Gender:F
Credentials:REGISTERED PHARMACIS
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:C
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED PHARMACIS
Mailing Address - Street 1:3750 GATTIS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4642
Mailing Address - Country:US
Mailing Address - Phone:512-341-3771
Mailing Address - Fax:512-341-0947
Practice Address - Street 1:3750 GATTIS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4642
Practice Address - Country:US
Practice Address - Phone:512-341-3771
Practice Address - Fax:512-341-0947
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist