Provider Demographics
NPI:1881853786
Name:OSTROWSKI, LISA MICHELE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MICHELE
Last Name:OSTROWSKI
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
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Mailing Address - Street 1:723 N FIELDER RD
Mailing Address - Street 2:STE C
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4697
Mailing Address - Country:US
Mailing Address - Phone:817-539-0959
Mailing Address - Fax:817-539-0480
Practice Address - Street 1:723 N FIELDER RD
Practice Address - Street 2:STE C
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4697
Practice Address - Country:US
Practice Address - Phone:817-539-0959
Practice Address - Fax:817-539-0480
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2014-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA01069363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant