Provider Demographics
NPI:1104166263
Name:BAILEY KHIRA, LISA ANNETTE
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANNETTE
Last Name:BAILEY KHIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KHIRA
Other - Middle Name:AKHU
Other - Last Name:AMUNET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5920 FAIRDALE LN APT 3
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-6341
Mailing Address - Country:US
Mailing Address - Phone:832-608-4828
Mailing Address - Fax:
Practice Address - Street 1:5920 FAIRDALE LN APT 3
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-6341
Practice Address - Country:US
Practice Address - Phone:832-608-4828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula