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General NPI Number Information
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NPI Number | 1659686657
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Entity Type | Individual
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Provider Name | LISA CHEUNG O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 5959 LONG DR STE K
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City | HOUSTON
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State | TX
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Zip | 77087-1000
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Country | US
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Telephone | 713-242-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 4844 KIERAN CT
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City | SANTA ROSA
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State | CA
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Zip | 95405-7400
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Country | US
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Telephone | 713-291-2477
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 15111
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License Number State | CA
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