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NPI Code Detail

MEDICARE: DR. LISA D. RASMUSSEN PSY.D.

MEDICARE: DR. LISA D. RASMUSSEN PSY.D.
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
1103TC0700XClinical PsychologistPY7412FL
2103T00000XPsychologist36870TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
190020OTHERFLBLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number : 1851457154
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA D. RASMUSSEN PSY.D.
Provider Business Mailing Address
First Line : 4603 ANDOVER CT
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3942
Country : US
Telephone Number : 713-818-6786
Fax Number :
Provider Business Practice Location Address
First Line : 1502 SAWYER ST STE 234
Second Line :
City : HOUSTON
State : TX
Zip : 77007-4446
Country : US
Telephone Number : 281-783-9297
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2006
Last Update Date : 03/27/2023

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