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General NPI Number Information
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NPI Number | 1588640007
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Entity Type | Individual
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Provider Name | LISE MORIN COPE M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 700 E MARSHALL AVE. DEPARTMENT OF PATHOLOGY
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City | LONGVIEW
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State | TX
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Zip | 75601-5580
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Country | US
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Telephone | 903-315-2403
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Fax | 903-315-1832
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Provider Business Mailing Address
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Address Line | ONE BAYLOR PLAZA #286A
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City | HOUSTON
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State | TX
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Zip | 77030-3411
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Country | US
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Telephone | 713-948-7000
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | H5594
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | H5594
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License Number State | TX
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