Provider Demographics
NPI:1700500154
Name:NIXON, LISA SKELTON
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SKELTON
Last Name:NIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 SANTA GERTRUDIS DR
Mailing Address - Street 2:
Mailing Address - City:SUTHERLAND SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78161-9709
Mailing Address - Country:US
Mailing Address - Phone:210-274-3886
Mailing Address - Fax:
Practice Address - Street 1:800 N RANCHO RD
Practice Address - Street 2:
Practice Address - City:NIXON
Practice Address - State:TX
Practice Address - Zip Code:78140-2626
Practice Address - Country:US
Practice Address - Phone:830-582-1536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist