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General NPI Number Information
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NPI Number | 1487621306
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Entity Type | Individual
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Provider Name | LISE AMY LABICHE
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Gender | Female
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 3535 S INTERSTATE 35 E
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City | DENTON
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State | TX
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Zip | 76210-6850
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Country | US
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Telephone | 940-384-3535
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Fax | 303-306-7753
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Provider Business Mailing Address
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Address Line | PO BOX 678186
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City | DALLAS
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State | TX
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Zip | 75267-8186
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Country | US
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Telephone | 303-306-7783
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Fax | 303-306-7753
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2356
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036-162508
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | K9830
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License Number State | TX
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