Individual
LISA R MASICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2000 S MAYS ST STE 201, ROUND ROCK, TX 78664-7580
(512) 244-4272
Mailing address
2000 S MAYS ST STE 201, ROUND ROCK, TX 78664-7580
(512) 244-4272
(956) 682-4154
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
702173
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP113013
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008949441
—
VA
01
—
00C40U
BCBS
TX
05
—
169583501
—
TX
05
—
169583502
—
TX
05
—
169583513
—
TX
01
—
84100Q
BCBS
TX
Enumeration date
01/04/2006
Last updated
01/13/2021
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