Provider Demographics
NPI:1205850443
Name:RISTER, LISA (DC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:RISTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:KABATOFF-HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:9303 PINECROFT DR.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2245
Mailing Address - Country:US
Mailing Address - Phone:281-292-6644
Mailing Address - Fax:281-298-1132
Practice Address - Street 1:9303 PINECROFT DR.
Practice Address - Street 2:SUITE 200
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2245
Practice Address - Country:US
Practice Address - Phone:281-292-6644
Practice Address - Fax:281-298-1132
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU-56990Medicare UPIN
TX8395MLMedicare PIN