Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | PA04698 | TX |
NPI | 1386661221 |
---|---|
Provider Name | Mrs. Lisa Marie Nolan |
First Address | Hondo, TX 78861 |
Second Address | Hondo, TX 78861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 04/12/2009 |