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General NPI Number Information
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NPI Number | 1598178998
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Entity Type | Individual
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Provider Name | LISA MARIE SCHAUBROECK AGNP
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Gender | Female
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 219 OAK DR S STE A
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City | LAKE JACKSON
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State | TX
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Zip | 77566-5675
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Country | US
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Telephone | 979-297-4033
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Fax |
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Provider Business Mailing Address
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Address Line | 6931 COUNTY ROAD 289
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City | SWEENY
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State | TX
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Zip | 77480-4036
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Country | US
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Telephone | 979-647-4820
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP125646
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP125646
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License Number State | TX
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