Individual
DR. LISA MARIE MICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
4110 GUADALUPE ST, AUSTIN, TX 78751-4223
(512) 419-2757
(512) 419-2788
Mailing address
4110 GUADALUPE ST, AUSTIN, TX 78751-4223
(512) 419-2757
(512) 419-2788
Taxonomy
Speciality
Code
Description
License number
State
1835P1300X
Psychiatric Pharmacist
Primary
39245
TX
Other
Enumeration date
06/30/2005
Last updated
12/02/2015
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