Provider Demographics
NPI:1801975230
Name:FOYTIK, LISA GUILFORD (MSN, GNP-C)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:GUILFORD
Last Name:FOYTIK
Suffix:
Gender:F
Credentials:MSN, GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N LOOP 336 E
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1437
Mailing Address - Country:US
Mailing Address - Phone:281-816-7333
Mailing Address - Fax:346-998-1442
Practice Address - Street 1:610 N LOOP 336 E
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1437
Practice Address - Country:US
Practice Address - Phone:281-816-7333
Practice Address - Fax:346-998-1442
Is Sole Proprietor?:No
Enumeration Date:2006-11-05
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64129163W00000X
TXAP115047363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX817N76OtherBCBS