Individual
MRS. SOFIA ANA LIESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 W COLLEGE ST STE 540, GRAPEVINE, TX 76051-3589
(817) 481-5863
(817) 329-8561
Mailing address
1600 W COLLEGE ST STE 540, GRAPEVINE, TX 76051-3589
(817) 481-5863
(817) 329-8561
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35120978
OH
207V00000X
Obstetrics & Gynecology Physician
Primary
Q4178
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0082670
—
OH
01
—
1033353099
BWC
OH
Enumeration date
04/21/2009
Last updated
06/02/2023
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