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Individual

DR. GREGORY CHARLES LIESER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6460 NAAMAN FOREST BLVD, GARLAND, TX 75044-5601
(972) 494-6764
(972) 494-6893
Mailing address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(972) 961-9482
(214) 696-4190

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
Q3726
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
348171501
TX
05
348171502
TX
Enumeration date
04/28/2009
Last updated
06/07/2018
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