Healthcare Provider Details

I. General information

NPI: 1447021407
Provider Name (Legal Business Name): LISSY MEJIAS SUBIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23410 GRAND RESERVE DR
KATY TX
77494-4985
US

IV. Provider business mailing address

2475 GRAY FALLS DR
HOUSTON TX
77077-6500
US

V. Phone/Fax

Practice location:
  • Phone: 832-437-0704
  • Fax:
Mailing address:
  • Phone: 786-368-4847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: