Provider Demographics
NPI:1346474756
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:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:512-892-7900
Mailing Address - Street 1:4544 S LAMAR BLVD STE 750
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1594
Mailing Address - Country:US
Mailing Address - Phone:512-892-7900
Mailing Address - Fax:512-280-9298
Practice Address - Street 1:12710 RESEARCH BLVD STE 117
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4380
Practice Address - Country:US
Practice Address - Phone:512-892-7900
Practice Address - Fax:512-280-9298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1150976225100000X
TX108508225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty