MEDICARE: MRS. LISA ANN HESTER MILLER 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
1	363A00000X	Physician Assistant	PA00490	TX

General Provider Information

NPI Number	:	1154363265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA ANN HESTER MILLER PA-C

Provider Business Mailing Address
First Line	:	819 N BROADWAY ST
Second Line	:
City	:	ASPERMONT
State	:	TX
Zip	:	79502-2029
Country	:	US
Telephone Number	:	940-989-3551
Fax Number	:	940-989-3395

Provider Business Practice Location Address
First Line	:	2300 VALLEY VIEW LN STE 330
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-1736
Country	:	US
Telephone Number	:	713-850-0049
Fax Number	:	713-627-7302

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	04/01/2020

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