Provider Demographics
NPI:1427182989
Name:LEAL, LIZA H (MD)
Entity Type:Individual
Prefix:DR
First Name:LIZA
Middle Name:H
Last Name:LEAL
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 1:4655 SWEETWATER BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3127
Mailing Address - Country:US
Mailing Address - Phone:281-265-6565
Mailing Address - Fax:
Practice Address - Street 1:4655 SWEETWATER BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3134
Practice Address - Country:US
Practice Address - Phone:281-265-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2735207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX48567Medicare UPIN