Individual
LISA LYNN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM,CPM
Contact information
Practice address
3917 HICKORY BEND TRL, MCKINNEY, TX 75071-2776
(214) 394-5687
(972) 562-5174
Mailing address
3917 HICKORY BEND TRL, MCKINNEY, TX 75071-2776
(214) 394-5687
(972) 562-5174
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
02008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02008
TEXAS MIDWIFERY LICENSE
TX
Enumeration date
01/18/2010
Last updated
01/18/2010
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