Individual
DR. LISA L GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7250 HAWKINS VIEW DR, STE 411, FORT WORTH, TX 76132-3920
(817) 644-1758
(817) 644-3112
Mailing address
7250 HAWKINS VIEW DR, STE 411, FORT WORTH, TX 76132-3920
(817) 644-1758
(817) 644-3112
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L9698
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172373602
—
TX
01
—
P00364785
RAILROAD MEDICARE
—
Enumeration date
07/13/2006
Last updated
10/24/2012
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