Organization
LISA A. KING M.D,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY ANN BASS (BUSINESS MANAGER)
(972) 709-9777
Entity
Organization
Contact information
Practice address
950 SCOTLAND DR, DESOTO, TX 75115-2057
(972) 709-9777
Mailing address
PO BOX 674298, DALLAS, TX 75267-4298
(972) 709-9777
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
J8015
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118575301
—
TX
Enumeration date
10/04/2006
Last updated
01/06/2020
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