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General NPI Number Information
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NPI Number | 1780699157
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Entity Type | Organization
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Legal Business Name | LUCY LI MDPA
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 9191 KYSER WAY BLDG 3 STE B
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 972-712-3131
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Fax | 972-712-7171
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Provider Business Mailing Address
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Address Line | 9191 KYSER WAY BLDG 3 STE B
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 972-712-3131
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Fax | 972-712-7171
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Authorized Official
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Title or Position | INSURANCE BILLING
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Name | JENE OLIVER
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Credential |
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Telephone | 972-712-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | L6496
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License Number State | TX
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