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Individual

LISA DEGARMO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
6550 FANNIN ST, SUITE 1601, HOUSTON, TX 77030-2717
(713) 441-5141
Mailing address
6550 FANNIN ST, SUITE 1601, HOUSTON, TX 77030-2717
(713) 441-5141

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
717207
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP119349
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063727485
BLUE CROSS BLUE SHIELD
TX
05
217937601
TX
01
217937602
MEDICAID CSHCN
TX
05
217937603
TX
01
827N59
BCBS
TX
01
P01048887
RR MEDICARE
TX
Enumeration date
08/10/2010
Last updated
01/24/2017
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