Individual
DR. ELMER J. LIZAMA
Active
Individual
DR. ELMER J. LIZAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22747
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116012902
—
TX
05
—
116012903
—
TX
05
—
116012904
—
TX
01
—
680007553
RAIL ROAD
TX
01
—
86075A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/05/2006
Last updated
07/09/2007
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