Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YP0228X | Pediatric Otolaryngology | E2549 | AR |
Y | 207YP0228X | Pediatric Otolaryngology | P3862 | TX |
NPI | 1033120399 |
---|---|
Provider Name | Dr. Lisa Mckay Buckmiller |
First Address | Dallas, TX 75373-3784 |
Second Address | Fort Worth, TX 76104-2722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 10/01/2022 |