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Individual

LISA D WEILER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSA; CSFA; LVN

Contact information

Practice address
14600 COUNTY LINE RD, WILLIS, TX 77378-4044
(936) 856-3598
(936) 856-3598
Mailing address
14600 COUNTY LINE RD, WILLIS, TX 77378-4044
(936) 203-1100
(936) 856-3598

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
188120
LVN
TX
01
203311
CSFA
01
SA00913
LSA
TX
Enumeration date
10/01/2010
Last updated
12/30/2022
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