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Individual
THERESE LAINE SISON
Active
Individual
THERESE LAINE SISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R1455
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370933903
—
TX
Enumeration date
04/02/2014
Last updated
04/23/2025
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