Provider Demographics
NPI:1508879669
Name:CHEN, LISA (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:CHEN
Other - Last Name:SHAMOO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:800 PEAKWOOD DR STE 2C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2913
Mailing Address - Country:US
Mailing Address - Phone:713-486-4650
Mailing Address - Fax:281-440-0759
Practice Address - Street 1:800 PEAKWOOD DR
Practice Address - Street 2:SUITE 2C
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2900
Practice Address - Country:US
Practice Address - Phone:281-440-7495
Practice Address - Fax:281-440-0759
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9753208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037013201Medicaid
TX80293KMedicare PIN