Healthcare Provider Details

I. General information

NPI: 1649492281
Provider Name (Legal Business Name): LISA SCHLEGEL LIC.AC., DIPL. O.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23535 IH-10 WEST SUITE 2205
SAN ANTONIO TX
78257
US

IV. Provider business mailing address

9325 CROSS MOUNTAIN TRL
SAN ANTONIO TX
78255-2011
US

V. Phone/Fax

Practice location:
  • Phone: 210-204-2305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00916
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: