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Individual
LISA M GARRISON
Active
Individual
LISA M GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04146
TX
363AS0400X
Surgical Physician Assistant
PA04146
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180506103
—
TX
01
—
630419YLLW
MEDICARE PTAN
TX
01
—
8JG175
BCBS
TX
Enumeration date
06/15/2006
Last updated
01/20/2022
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