Individual
LISAVIC CERICOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
8607 KEILA ORCH, SAN ANTONIO, TX 78251-2598
(210) 617-5300
Mailing address
8607 KEILA ORCHARD, SAN ANTONIO, TX 78251
(210) 617-5300
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
685200
TX
Other
Enumeration date
03/27/2026
Last updated
03/27/2026
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