Provider Demographics
NPI:1194917088
Name:ROYER, LISA MICHELLE (PTA)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MICHELLE
Last Name:ROYER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 WOODLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5102
Mailing Address - Country:US
Mailing Address - Phone:713-213-1895
Mailing Address - Fax:
Practice Address - Street 1:1377 S VOSS RD
Practice Address - Street 2:REHAB
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-1023
Practice Address - Country:US
Practice Address - Phone:713-979-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2029718261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy