Lisa Blair, PA-C

Individual provider Active NPI Physician Assistant · Granbury, TX

NPI 1871675348 · NPPES record last updated Jun 11, 2018

Key facts

NPI
1871675348
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
00381 (TX)
Practice address
1310 B Paluxy Road
Suite 2000
Granbury, TX 76048
Phone
(817) 579-3700
Fax
(817) 279-3715
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00381TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00381 TX Yes

Addresses

Primary practice location

1310 B Paluxy Road
Suite 2000
Granbury, TX 76048

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other providers in Granbury, TX

All providers in Granbury, TX · Physician Assistant in Texas

Sources for this page

Verify at the official NPI Registry.