Individual
LISA DIANE MIJARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
6844 HARRIS PARKWAY, FORT WORTH, TX 76132
(817) 263-0007
(817) 263-1118
Mailing address
6844 HARRIS PARKWAY, FORT WORTH, TX 76132
(817) 263-0007
(817) 529-2640
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP127690
TX
363LA2200X
Adult Health Nurse Practitioner
AP127690
TX
363LG0600X
Gerontology Nurse Practitioner
AP127690
TX
Other
Enumeration date
03/25/2015
Last updated
06/30/2023
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