Provider Demographics
NPI:1356442768
Name:EHRLICH, LISA LEE (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LEE
Last Name:EHRLICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2535 KIRBY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-6320
Mailing Address - Country:US
Mailing Address - Phone:713-800-8800
Mailing Address - Fax:713-800-8849
Practice Address - Street 1:2535 KIRBY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-6320
Practice Address - Country:US
Practice Address - Phone:713-800-8800
Practice Address - Fax:713-800-8849
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG33096Medicare UPIN
TX8362B0Medicare ID - Type UnspecifiedINDIVIDUAL ID NUMBER