Provider Demographics
NPI:1649382979
Name:KITE, LISA LEA (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:LEA
Last Name:KITE
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 1:3614 LANCASHIRE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6632
Mailing Address - Country:US
Mailing Address - Phone:713-492-2133
Mailing Address - Fax:713-492-2103
Practice Address - Street 1:3614 LANCASHIRE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6632
Practice Address - Country:US
Practice Address - Phone:713-492-2133
Practice Address - Fax:713-492-2103
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9766207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI47760Medicare UPIN
TX8551Medicare ID - Type Unspecified