Individual
DR. KRISTIE LISKA BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3144 HORIZON RD STE 210, ROCKWALL, TX 75032
(972) 771-2222
(972) 771-3350
Mailing address
7610 N STEMMONS FWY STE 600, DALLAS, TX 75247-4228
(214) 689-5960
(469) 713-8084
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
M6531
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1885543-02
—
TX
01
—
8CY616
BCBSTX
TX
01
—
P00467137
RR MCR PTAN
TX
Enumeration date
06/14/2007
Last updated
06/27/2018
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