Individual
LISE AMY LABICHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 S INTERSTATE 35 E, DENTON, TX 76210-6850
(940) 384-3535
(303) 306-7753
Mailing address
PO BOX 678186, DALLAS, TX 75267-8186
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
036-162508
IL
2084N0400X
Neurology Physician
2356
WI
2084N0400X
Neurology Physician
Primary
K9830
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100221656
—
WI
05
—
158290002
—
TX
01
—
K9830
TEXAS MEDICAL LICENSE
TX
01
—
P00477936
RR MEDICARE
TX
Enumeration date
03/01/2006
Last updated
10/04/2024
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