Provider Demographics
NPI:1760249544
Name:PAULISE, LUCIANA
Entity Type:Individual
Prefix:
First Name:LUCIANA
Middle Name:
Last Name:PAULISE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19922 ASTILBE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3756
Mailing Address - Country:US
Mailing Address - Phone:409-626-4995
Mailing Address - Fax:
Practice Address - Street 1:19922 ASTILBE CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3756
Practice Address - Country:US
Practice Address - Phone:409-626-4995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health