Individual
DR. JEROME P LISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
3537 S I 35 E STE 112, DENTON, TX 76210-6868
(940) 383-1770
(833) 992-0840
Mailing address
3537 S I 35 E STE 112, DENTON, TX 76210-6868
(940) 383-1770
(833) 992-0840
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2004029825
MO
2084N0400X
Neurology Physician
A88331
CA
2084N0400X
Neurology Physician
Primary
R1074
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193247
BLUE CROSS/BLUE SHIELD
—
05
—
207238106
—
MO
05
—
366511901
—
TX
01
—
P00890011
MEDICARE RAILROAD
CA
01
—
P01773741
RAIL ROAD MEDICARE
TX
Enumeration date
06/03/2006
Last updated
04/03/2026
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