Provider Demographics
NPI:1881466951
Name:DHUKA, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DHUKA
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 1:26400 KUYKENDAHL RD STE C220
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77375-1580
Mailing Address - Country:US
Mailing Address - Phone:281-713-9011
Mailing Address - Fax:
Practice Address - Street 1:26400 KUYKENDAHL RD STE C220
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77375-1580
Practice Address - Country:US
Practice Address - Phone:281-713-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17117363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant