Individual
DR. LISA BETH WILLIFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6451 BRENTWOOD STAIR RD STE 200, FORT WORTH, TX 76112-3200
(817) 496-9700
Mailing address
6451 BRENTWOOD STAIR RD STE 200, FORT WORTH, TX 76112-3200
(817) 496-9700
(919) 966-3049
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
P2401
TX
390200000X
Student in an Organized Health Care Education/Training Program
156985
NC
Other
Enumeration date
06/11/2009
Last updated
10/05/2022
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