Provider Demographics
NPI:1396717294
Name:SKARIAH, LISA K (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:K
Last Name:SKARIAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 GRANDE BLVD
Mailing Address - Street 2:APT 1703
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0602
Mailing Address - Country:US
Mailing Address - Phone:512-789-8312
Mailing Address - Fax:
Practice Address - Street 1:11937 HWY 271
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75708-3154
Practice Address - Country:US
Practice Address - Phone:903-877-7090
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist