Individual
DR. LISA ANN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O., MPH
Contact information
Practice address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-1952
Mailing address
340 EL PORTAL DR, HOLLYWOOD PARK, TX 78232-2110
(301) 219-0392
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
DO-667
AL
2083X0100X
Occupational Medicine Physician
Primary
Q5622
TX
Other
Enumeration date
02/07/2006
Last updated
05/14/2020
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