Provider Demographics
NPI:1699002220
Name:LEKOUSIS, LISA M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:M
Last Name:LEKOUSIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9810 S MASON RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406
Mailing Address - Country:US
Mailing Address - Phone:835-595-9533
Mailing Address - Fax:832-595-9574
Practice Address - Street 1:9810 S MASON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406
Practice Address - Country:US
Practice Address - Phone:835-595-9533
Practice Address - Fax:832-595-9574
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43806183500000X
IL051-290706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist