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Individual

DR. LISA J HERRIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4200 SOUTH FWY STE 100, FORT WORTH, TX 76115-1407
(817) 750-7334
Mailing address
14100 SAN PEDRO AVE STE 600, SAN ANTONIO, TX 78232-4363
(210) 981-1975
(817) 568-5474

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
H4400
TX
208000000X
Pediatrics Physician
Primary
H4400
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0087LE
BCBSTX GRP PIN
TX
01
1003887985
GRP NPI NUMBER
05
132731409
TX
05
132731411
TX
05
140442857
TX
05
163314101
TX
01
1729016
FIRSTHEALTH PIN
TX
01
4586688
AETNA PIN
TX
01
6811699
CIGNA PIN
TX
01
8M3077
BCBSTX IND PIN
TX
01
9057411
PHCS PIN
TX
Enumeration date
10/02/2006
Last updated
04/14/2023
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