Provider Demographics
NPI:1720128192
Name:JUBERT, LISA GAIL (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:GAIL
Last Name:JUBERT
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5402 BALMORHEA DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1449
Mailing Address - Country:US
Mailing Address - Phone:281-692-1972
Mailing Address - Fax:
Practice Address - Street 1:7501 FANNIN ST
Practice Address - Street 2:SUITE 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1903
Practice Address - Country:US
Practice Address - Phone:713-790-7821
Practice Address - Fax:713-790-1620
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist