Individual
LISE MORIN COPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
700 E MARSHALL AVE., DEPARTMENT OF PATHOLOGY, LONGVIEW, TX 75601-5580
(903) 315-2403
(903) 315-1832
Mailing address
ONE BAYLOR PLAZA, #286A, HOUSTON, TX 77030-3411
(713) 948-7000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
H5594
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H5594
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006600972
MEDICAID - LGP
VA
05
—
010273714
—
VA
01
—
011265L84
MEDICARE - LGP
—
Enumeration date
12/16/2005
Last updated
09/20/2022
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