Individual
LISA SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1411 N BECKLEY AVE STE 370, DALLAS, TX 75203-1513
(214) 358-2300
(214) 366-6461
Mailing address
1505 LBJ FWY STE 700, DALLAS, TX 75234-6065
(214) 358-2300
(214) 579-6941
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
K3850
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K3850
MEDICAL LICENSE
TX
Enumeration date
01/30/2006
Last updated
05/08/2024
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