Individual
MRS. LISA MARIE HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., L.D.
Contact information
Practice address
102 MONTEGO CT, VICTORIA, TX 77901-3724
(361) 570-8355
Mailing address
102 MONTEGO CT, VICTORIA, TX 77901-3724
(361) 570-8355
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
848468
TX
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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