Provider Demographics
NPI:1295930055
Name:OCHOA, LISA L (DDS)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:L
Last Name:OCHOA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12918 SHOPS PKWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6628
Mailing Address - Country:US
Mailing Address - Phone:512-263-8900
Mailing Address - Fax:
Practice Address - Street 1:12918 SHOPS PKWY
Practice Address - Street 2:SUITE 450
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738-6628
Practice Address - Country:US
Practice Address - Phone:512-263-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice