Organization
LISARA DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA ANN QUINTANILLA (OWNER)
(210) 614-3003
Entity
Organization
Contact information
Practice address
7220 LOUIS PASTEUR DR STE 160, STE 160, SAN ANTONIO, TX 78229-4535
(210) 614-3003
(210) 692-7898
Mailing address
4319 MEDICAL DR # 131-113, SAN ANTONIO, TX 78229-3381
(210) 614-3003
(210) 692-7898
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L2885
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3553429
AETNA ID NUMBER
TX
Enumeration date
08/08/2006
Last updated
08/22/2020
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