Provider Demographics
NPI:1033935689
Name:LENSICO, LIZA MARTINEZ (NP-C)
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:MARTINEZ
Last Name:LENSICO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13737 HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:NEEDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77461-7516
Mailing Address - Country:US
Mailing Address - Phone:979-793-3940
Mailing Address - Fax:
Practice Address - Street 1:13737 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:NEEDVILLE
Practice Address - State:TX
Practice Address - Zip Code:77461-7516
Practice Address - Country:US
Practice Address - Phone:979-793-3940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1177701363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology