Healthcare Provider Details

I. General information

NPI: 1639615263
Provider Name (Legal Business Name): LISA PAMPLIN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 RIVER POINTE DR STE 120
CONROE TX
77304-2943
US

IV. Provider business mailing address

930 FROSTWOOD DR STE 2.200
HOUSTON TX
77024-2450
US

V. Phone/Fax

Practice location:
  • Phone: 936-788-6060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP132942
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: