Organization
JULIA LIACI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMIE M JACKSON (BILLING MGR)
(469) 916-4767
Entity
Organization
Contact information
Practice address
8210 WALNUT HILL LN, SUITE 700, DALLAS, TX 75231-4405
(214) 271-4600
(214) 271-4604
Mailing address
8210 WALNUT HILL LN, SUITE 700, DALLAS, TX 75231-4405
(214) 271-4600
(214) 271-4604
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L8111
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089MP
BCBS
TX
05
—
165596106
—
TX
Enumeration date
06/18/2008
Last updated
06/18/2008
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