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NPI Code Detail

MEDICARE: LISA MARIE CLEVELAND NP

MEDICARE: LISA MARIE CLEVELAND NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WG0000XGeneral Practice Registered Nurse663765TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1376046402OTHERTXCSHCN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457675068
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE CLEVELAND NP
Provider Business Mailing Address
First Line : 7400 MERTON MINTER ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-4404
Country : US
Telephone Number : 210-617-5300
Fax Number :
Provider Business Practice Location Address
First Line : 7400 MERTON MINTER ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-4404
Country : US
Telephone Number : 210-617-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2010
Last Update Date : 06/08/2026

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