Provider Demographics
NPI:1275904757
Name:LISING-PHAM, MARIA I (MS, ATP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:
Last Name:LISING-PHAM
Suffix:I
Gender:F
Credentials:MS, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:10518 KIPP WAY DR
Mailing Address - Street 2:UNIT D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-2400
Mailing Address - Country:US
Mailing Address - Phone:713-270-4936
Mailing Address - Fax:713-270-0343
Practice Address - Street 1:10518 KIPP WAY DR
Practice Address - Street 2:UNIT D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-2400
Practice Address - Country:US
Practice Address - Phone:713-270-4936
Practice Address - Fax:713-270-0343
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP85924225CA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner