Provider Demographics
NPI:1891904967
Name:HOU, LISA JENNY (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:JENNY
Last Name:HOU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:JENNY
Other - Last Name:SHIVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-0201
Mailing Address - Country:US
Mailing Address - Phone:908-309-5442
Mailing Address - Fax:
Practice Address - Street 1:BLDG 64 ACADEMY WAY
Practice Address - Street 2:MEDICAL COMMAND - NATIONAL GUARD TRAINING CENTER
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750
Practice Address - Country:US
Practice Address - Phone:732-974-5910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB 07166200207YS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine