Individual
DR. LISA DIANE PERSYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12180 N MOPAC EXPY, AUSTIN, TX 78758-2909
(512) 836-8800
(512) 836-8801
Mailing address
19016 STONE OAK PKWY STE 280, SAN ANTONIO, TX 78258-3337
(210) 545-5128
(210) 545-5120
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
L3778
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177678301
—
TX
01
—
8K2535
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/02/2006
Last updated
03/24/2014
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