Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | P6861 | TX |
N | 2086S0105X | Surgery of the Hand | P6861 | TX |
NPI | 1962662684 |
---|---|
Provider Name | Dr. Lisa K Longhofer |
First Address | Amarillo, TX 79124-1636 |
Second Address | Amarillo, TX 79124-1636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 23/07/2019 |