Provider Demographics
NPI:1093950511
Name:HOUGHTELING, LISA N (PHD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:N
Last Name:HOUGHTELING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:STALLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7272 WURZBACH RD
Mailing Address - Street 2:AUITE 601
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4801
Mailing Address - Country:US
Mailing Address - Phone:210-615-8880
Mailing Address - Fax:210-593-9863
Practice Address - Street 1:2501 OAK LAWN
Practice Address - Street 2:SUITE 201
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-4019
Practice Address - Country:US
Practice Address - Phone:214-559-2192
Practice Address - Fax:210-593-9863
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33985103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical