Provider Demographics
NPI:1114931086
Name:LISA HARRIS, OTR, PC
Entity Type:Organization
Organization Name:LISA HARRIS, OTR, PC
Other - Org Name:AUSTIN HEALTHWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STREATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-892-7900
Mailing Address - Street 1:4544 S LAMAR BLVD
Mailing Address - Street 2:STE 750
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1500
Mailing Address - Country:US
Mailing Address - Phone:512-892-7900
Mailing Address - Fax:512-892-9298
Practice Address - Street 1:4544 S LAMAR BLVD
Practice Address - Street 2:STE # 750
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1500
Practice Address - Country:US
Practice Address - Phone:512-892-7900
Practice Address - Fax:512-892-9298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicare PIN