Individual
LISA INTHAVILAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11221 TRIPLE CROWN DR, FLINT, TX 75762-6333
(214) 708-1998
Mailing address
11221 TRIPLE CROWN DR, FLINT, TX 75762-6333
(214) 708-1998
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
309699
TX
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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