Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 23665 | TX |
NPI | 1003064403 |
---|---|
Provider Name | Lisa Lachelle Mcgriff-Metz |
First Address | Missouri City, TX 77459 |
Second Address | Missouri City, TX 77459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2008 |
Last Update Date | 08/10/2009 |