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NPI Code Detail

MEDICARE: LISA HU PA-C

MEDICARE: LISA HU PA-C
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
1363AM0700XMedical Physician AssistantPATX

General Provider Information

NPI Number : 1730579376
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA HU PA-C
Provider Business Mailing Address
First Line : 1810 COMMERCE ST APT 814
Second Line :
City : DALLAS
State : TX
Zip : 75201-5395
Country : US
Telephone Number : 469-569-5528
Fax Number :
Provider Business Practice Location Address
First Line : 1251 E RED BIRD LN
Second Line :
City : DALLAS
State : TX
Zip : 75241-2008
Country : US
Telephone Number : 214-374-0827
Fax Number : 214-374-0927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2015
Last Update Date : 02/04/2015

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