Provider Demographics
NPI:1467170951
Name:CAUSEY, LISA (LMT, LMTI)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:CAUSEY
Suffix:
Gender:F
Credentials:LMT, LMTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10034
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76547-0034
Mailing Address - Country:US
Mailing Address - Phone:254-393-4057
Mailing Address - Fax:
Practice Address - Street 1:101 W FM 2410 RD STE C
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1806
Practice Address - Country:US
Practice Address - Phone:254-393-4057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT132853225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherLICENSED MASSAGE THERAPIST