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NPI Code Detail

MEDICARE: LISA K BOAGNI

MEDICARE: LISA K BOAGNI
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
1183700000XPharmacy Technician

General Provider Information

NPI Number : 1710576111
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA K BOAGNI
Provider Business Mailing Address
First Line : 7025 VILLAGE CENTER DR
Second Line :
City : AUSTIN
State : TX
Zip : 78731-3023
Country : US
Telephone Number : 512-502-8810
Fax Number :
Provider Business Practice Location Address
First Line : 7025 VILLAGE CENTER DR
Second Line :
City : AUSTIN
State : TX
Zip : 78731-3023
Country : US
Telephone Number : 512-502-8810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2021
Last Update Date : 01/11/2021

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Directions to “ LISA K BOAGNI ” Practice Location

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