Provider Demographics
NPI:1962441063
Name:LAU, LISA TAK-HING (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:TAK-HING
Last Name:LAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4008 LOUETTA RD # 101
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4405
Mailing Address - Country:US
Mailing Address - Phone:832-779-3330
Mailing Address - Fax:832-779-2475
Practice Address - Street 1:12822 VETERANS MEMORIAL DR # 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-2049
Practice Address - Country:US
Practice Address - Phone:832-779-3330
Practice Address - Fax:832-779-2475
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8496208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02579115Medicaid