Provider Demographics
NPI:1174631238
Name:HAMRIC, LISA RENE (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RENE
Last Name:HAMRIC
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 CINNAMON CIR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3466
Mailing Address - Country:US
Mailing Address - Phone:214-492-9722
Mailing Address - Fax:
Practice Address - Street 1:203 CINNAMON CIR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-3466
Practice Address - Country:US
Practice Address - Phone:214-492-9722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT14122255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer