DR. LISA MARIE MICAN (NPI# 1932106424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932106424 |
Entity Type | Individual |
Full Name | DR. LISA MARIE MICAN |
Credential | PHARM.D. |
Practice Address |
4110 Guadalupe St Austin TX 78751-4223 |
Practice Telephone | 5124192757 |
Practice Fax Number | 5124192788 |
Mailing Telephone | 5124192757 |
Mailing Fax Number | 5124192788 |
Enumeration Date | 2005-06-30 |
Last Update Date | 2015-12-02 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P1300X |
Pharmacist Specialization: Psychiatric |
39245 | TX | Pharmacy Service Providers |
Street Address |
4110 GUADALUPE ST |
City | AUSTIN |
State | TX |
Zip Code | 78751-4223 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619972411 | Eulon Ross Taylor | Psychiatry & Neurology | 4110 Guadalupe St, Austin State Hospital, Austin, TX 78751-4223 | 2005-06-17 |
1396359261 | Laura Adzoa Kumordzie | Nurse Practitioner | 4110 Guadalupe St, Austin, TX 78751-4223 | 2020-09-08 |
1154943462 | Lyndsay Brooks | Psychologist | 4110 Guadalupe St, Austin, TX 78751-4223 | 2020-05-08 |
1427684133 | Tanya Marie Escobar | Occupational Therapist | 4110 Guadalupe St, Austin, TX 78751-4223 | 2020-03-14 |
1821636663 | Victoria Freberg | Pharmacist | 4110 Guadalupe St, Austin, TX 78751-4223 | 2019-12-11 |
1891272449 | Vidisha Rohit Paranjpe | Dietitian, Registered | 4110 Guadalupe St, Austin, TX 78751-4223 | 2018-07-26 |
1205388337 | Bayo Olaoye | Nurse Practitioner | 4110 Guadalupe St, Austin, TX 78751-4223 | 2016-10-24 |
1265807028 | Ann Wilson | Pharmacist | 4110 Guadalupe St, Austin, TX 78751-4223 | 2015-12-04 |
1447625298 | Sara Jane Vershaw | Pharmacist | 4110 Guadalupe St, Austin, TX 78751-4223 | 2015-12-04 |
1679947204 | Escania Nichole Hoyt | Registered Nurse | 4110 Guadalupe St, Austin, TX 78751-4223 | 2015-11-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235657867 | Joy Miller | Social Worker | 4920 N Ih 35 Suite 110, Austin, TX 78751 | 2017-09-04 |
1053859306 | Metabolic Therapy Inc. | Pharmacy | 4103 Avenue D, Austin, TX 78751 | 2017-02-07 |
1316390438 | Hillary Guest | Speech-Language Pathologist | 5406 Middle Fiskville Rd Apt 410, Austin, TX 78751 | 2016-07-14 |
1891151866 | Simonek Vision, Pllc | Optometrist | 1000 E. 41st Street, Suite 120, Austin, TX 78751 | 2016-01-06 |
1750771911 | Angela Ziskis | Psychologist | 4110 Gualdalupe Street, Building 794, Specialty Services, Austin, TX 78751 | 2015-01-27 |
1750783841 | Lizette Araujo | Psychologist | 5225 North Lamar Blvd., Austin, TX 78751 | 2014-09-19 |
1013323724 | Matrix Therapy, LLC | Clinic/Center | 5204 Avenue F, Austin, TX 78751 | 2014-07-02 |
1215281738 | Elizabeth Ann White | Clinical Nurse Specialist | 818 East 53rd Street, Austin, TX 78751 | 2012-11-06 |
1619259934 | Samir K Momin | Dentist | 1000 E 41st Street, Suite 230, Austin, TX 78751 | 2011-09-13 |
1467740753 | Gary G. Plakias | Technician, Other | 5400 N Lamar Blvd, 206b, Austin, TX 78751 | 2011-07-20 |
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Taxonomy Code | 1835P1300X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Psychiatric |
A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |
Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified title, added definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669900833 | Samantha Marie Vogel | Pharmacist | 1301 W 38th St Ste 700, Austin, TX 78705-1016 | 2017-05-31 |
1053761676 | Nina Vadiei | Pharmacist | 3400 Harmon Ave Apt 469, Austin, TX 78705-2375 | 2016-06-14 |
1407106750 | Morgan Snyder | Pharmacist | 7603 Eastcrest Dr, Austin, TX 78752-1409 | 2012-09-13 |
1134407802 | Tawny Smith | Pharmacist | 3501 Mills Ave, Austin, TX 78731-6309 | 2011-07-29 |
1417070194 | Stacy Catherine Mendelson | Pharmacist | 9900 Spectrum Dr, Austin, TX 78717-4555 | 2007-04-09 |
1003813031 | Terry Lynn Green-witty | Pharmacist | 3501 Mills Ave, Austin, TX 78731-6309 | 2005-07-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336341254 | Jerry Wade Lee | Pharmacist | 1950 Aspen, Lubbock, TX 79403 | 2007-06-04 |
1104047364 | Ronald Leon Thomas | Pharmacist | 1350 N. Westmoreland, Pharmacy Service, Dallas, TX 75211 | 2007-05-02 |
1184717688 | Crystal Henderson | Pharmacist | 1001 Lake Carolyn Pkwy Apt 516, Irving, TX 75039-4816 | 2006-10-02 |
1174513972 | Catherine Susan Hall | Pharmacist | 325 Wallace St, Seguin, TX 78155-5959 | 2005-10-24 |
1013902519 | Leah B Nunez | Pharmacist | 1401 S Rangerville Rd, Harlingen, TX 78552-7638 | 2005-09-12 |
1740281716 | Mishelle R Seiler | Pharmacist | 8720 Country Glen Xing, Plano, TX 75024-3780 | 2005-08-02 |
1427058346 | Delphina Chikamele Mitima-samuel | Pharmacist | 9727 Mckinney Ln, Missouri City, TX 77459 | 2005-07-21 |
1568460202 | Lawrence J Cohen | Pharmacist | 3500 Camp Bowie Blvd, Fort Worth, TX 76107-2644 | 2005-07-07 |
1386641017 | Jennifer D. Faulkner | Pharmacist | 1901 Veterans Memorial Dr, Mhc 116, Temple, TX 76504-7451 | 2005-07-07 |
1609873694 | William Henry Benefield Jr. | Pharmacist | 4502 Meredith Woods St, San Antonio, TX 78249-1410 | 2005-07-05 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.