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General NPI Number Information
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NPI Number | 1073826442
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Entity Type | Individual
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Provider Name | LIZA JEMISON MD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 1330 KINGWOOD DR SUITE 200
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City | KINGWOOD
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State | TX
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Zip | 77339-3038
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Country | US
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Telephone | 281-348-7301
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Fax | 281-348-2186
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Provider Business Mailing Address
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Address Line | 1330 KINGWOOD DR SUITE 200
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City | KINGWOOD
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State | TX
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Zip | 77339-3038
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Country | US
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Telephone | 281-348-7301
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Fax | 281-348-2186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10037630
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License Number State | TX
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