Healthcare Provider Details

I. General information

NPI: 1780858167
Provider Name (Legal Business Name): LISA NASSIF WRIGHT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 05/06/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 PLAINVIEW ST STE 8
PASADENA TX
77504-1929
US

IV. Provider business mailing address

3618 EMERALD FALLS DR
HOUSTON TX
77059-3738
US

V. Phone/Fax

Practice location:
  • Phone: 713-589-7020
  • Fax: 713-554-2031
Mailing address:
  • Phone: 713-589-7020
  • Fax: 713-554-2031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM8643
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberM8643
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberM8643
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: