Individual
DR. LISA WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12600 HILL COUNTRY BLVD, SUITE R-103, AUSTIN, TX 78738-6723
(512) 892-7076
Mailing address
5625 EIGER RD, SUITE 200, AUSTIN, TX 78735-8982
(512) 892-7076
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G5126
TX
Other
Enumeration date
03/10/2009
Last updated
02/17/2017
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