MEDICARE: LISANDRA LEMUS CARRILES APRN-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	921955	TX

General Provider Information

NPI Number	:	1831688217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISANDRA LEMUS CARRILES APRN-CNP

Provider Business Mailing Address
First Line	:	11821 EAST FWY # 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77029-1975
Country	:	US
Telephone Number	:	832-460-2190
Fax Number	:

Provider Business Practice Location Address
First Line	:	11821 EAST FWY # 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77029-1975
Country	:	US
Telephone Number	:	832-460-2190
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2018
Last Update Date	:	05/31/2025

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