MEDICARE: WARRENMED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1407654197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARRENMED

Provider Business Mailing Address
First Line	:	700 W FM 78 STE 203
Second Line	:
City	:	CIBOLO
State	:	TX
Zip	:	78108-3553
Country	:	US
Telephone Number	:	210-793-7993
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 W FM 78 STE 203
Second Line	:
City	:	CIBOLO
State	:	TX
Zip	:	78108-3553
Country	:	US
Telephone Number	:	210-688-8486
Fax Number	:	210-688-8487

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LISA WARREN
Credential	:	APRN
Telephone Number	:	210-771-2208

Provider Enumeration Date	:	03/06/2025
Last Update Date	:	05/01/2025

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1881363018 — LISA GAYLE WARREN NP
Practice Location Address:

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Directions to “WARRENMED ” Practice Location

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