Provider Demographics
NPI:1164827192
Name:POLLARD, LISA (CSA)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:POLLARD
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 COVENTRY SQUARE DR
Mailing Address - Street 2:#425
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1455
Mailing Address - Country:US
Mailing Address - Phone:281-840-2549
Mailing Address - Fax:
Practice Address - Street 1:9401 COVENTRY SQUARE DR
Practice Address - Street 2:#425
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1455
Practice Address - Country:US
Practice Address - Phone:281-840-2549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant