Provider Demographics
NPI:1700557659
Name:BRIZUELA AGUILAR, LISANDRA (ARNP)
Entity type:Individual
Prefix:
First Name:LISANDRA
Middle Name:
Last Name:BRIZUELA AGUILAR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20502 BADEN HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1717
Mailing Address - Country:US
Mailing Address - Phone:305-479-5718
Mailing Address - Fax:
Practice Address - Street 1:20502 BADEN HOLLOW LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1717
Practice Address - Country:US
Practice Address - Phone:305-479-5718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1048102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily