Provider Demographics
NPI:1932259710
Name:QIU, LISHA (MS)
Entity Type:Individual
Prefix:MRS
First Name:LISHA
Middle Name:
Last Name:QIU
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5938 TAPESTRY DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-6338
Mailing Address - Country:US
Mailing Address - Phone:626-524-0986
Mailing Address - Fax:
Practice Address - Street 1:5866 S STAPLES ST
Practice Address - Street 2:SUITE 401
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3700
Practice Address - Country:US
Practice Address - Phone:361-991-7884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2009-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9976171100000X
TX1034171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist