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General NPI Number Information
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NPI Number | 1073739090
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Entity Type | Organization
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Legal Business Name | LISA M. JUKES, MD, PA
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 5656 BEE CAVE RD SUITE B101
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5280
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Country | US
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Telephone | 512-301-6767
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Fax | 512-301-6776
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Provider Business Mailing Address
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Address Line | 5656 BEE CAVE RD SUITE B101
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5280
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Country | US
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Telephone | 512-301-6767
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Fax | 512-301-6776
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Authorized Official
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Title or Position | OWNER, PHYSICIAN
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Name | DR. LISA MARGARET JUKES
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Credential | M.D.
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Telephone | 512-301-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | K6767
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | K6767
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License Number State | TX
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