Individual
LISA LARAINE SOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(832) 355-2666
Mailing address
9373 N WALKER RD, CLEVELAND, TX 77328-5835
(832) 797-9670
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
1134088
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
1134088
TX
Other
Enumeration date
11/08/2023
Last updated
11/14/2025
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