Provider Demographics
NPI:1760842363
Name:MARCEAUX, LISA CAROL
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:CAROL
Last Name:MARCEAUX
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 1:16826 JUDYLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1949
Mailing Address - Country:US
Mailing Address - Phone:281-861-0394
Mailing Address - Fax:
Practice Address - Street 1:16826 JUDYLEIGH DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1949
Practice Address - Country:US
Practice Address - Phone:281-861-0394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator