Individual
DR. LISA DANIELLE BROSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, FACS
Contact information
Practice address
3551 ROGER BROOKE DR BLDG 3600, FORT SAM HOUSTON, TX 78234-4504
(210) 269-6113
Mailing address
3551 ROGER BROOKE DR BLDG 3600, FORT SAM HOUSTON, TX 78234-4504
(210) 269-6113
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
L4266
TX
Other
Enumeration date
11/06/2006
Last updated
09/12/2019
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