Individual
LISA MARIE PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1108 LAVACA ST, AUSTIN, TX 78701-2172
(512) 477-4088
Mailing address
6141 TURNERSVILLE RD, CREEDMOOR, TX 78610-3920
(512) 217-7560
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
1035476
TX
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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