Individual
LISA I PEGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3323 BROOKS LN, TYLER, TX 75701-6151
(936) 676-0392
Mailing address
3323 BROOKS LN, TYLER, TX 75701-6151
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT82905
TX
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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