Individual
DR. LISA B. VANWAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6201 HARRY HINES BLVD, DALLAS, TX 75390-3111
(214) 633-5555
Mailing address
PO BOX 845347, DALLAS, TX 75284-7208
(214) 645-6284
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
036124551
IL
207RG0100X
Gastroenterology Physician
Primary
T5230
TX
207RI0008X
Hepatology Physician
036124551
IL
207RI0008X
Hepatology Physician
T5230
TX
207RT0003X
Transplant Hepatology Physician
036124551
IL
207RT0003X
Transplant Hepatology Physician
T5230
TX
Other
Enumeration date
03/19/2008
Last updated
07/18/2022
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