Provider Demographics
NPI:1922357888
Name:FLETCHER, LARISSA ADKINS (MD)
Entity Type:Individual
Prefix:DR
First Name:LARISSA
Middle Name:ADKINS
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LARISSA
Other - Middle Name:GAIL
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13211 HARGRAVE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4311
Mailing Address - Country:US
Mailing Address - Phone:281-477-8660
Mailing Address - Fax:832-678-2881
Practice Address - Street 1:13211 HARGRAVE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4311
Practice Address - Country:US
Practice Address - Phone:281-477-8660
Practice Address - Fax:832-678-2881
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4310208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics