Provider Demographics
NPI:1164648754
Name:MCADAMS, LISA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:MCADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1301 YOUNG ST
Mailing Address - Street 2:ROOM 833
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-5433
Mailing Address - Country:US
Mailing Address - Phone:214-767-6456
Mailing Address - Fax:214-767-6454
Practice Address - Street 1:1301 YOUNG ST
Practice Address - Street 2:ROOM 833
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-5433
Practice Address - Country:US
Practice Address - Phone:214-767-6456
Practice Address - Fax:214-767-6454
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH25772083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C19006Medicare UPIN