Provider Demographics
NPI:1881130797
Name:MORRIS, LISA MICHELLE (RPH, CGP, FASCP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELLE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RPH, CGP, FASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6003 OLD OAK CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-9615
Mailing Address - Country:US
Mailing Address - Phone:281-787-0306
Mailing Address - Fax:
Practice Address - Street 1:6003 OLD OAK CIR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-9615
Practice Address - Country:US
Practice Address - Phone:281-787-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST015603183500000X
TX319281835G0303X
NMRP000086201835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist