Individual
DR. LISA CAROLE ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
341 E PARKWOOD AVE, FRIENDSWOOD, TX 77546-5147
(281) 400-3301
(281) 400-3307
Mailing address
PO BOX 1808, FRIENDSWOOD, TX 77549-1808
(281) 400-3301
(281) 400-3307
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H2742
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098513703
—
TX
01
—
200379218
TAX ID
TX
Enumeration date
08/25/2006
Last updated
06/26/2009
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