Provider Demographics
NPI:1134551328
Name:LISA ROY MD PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:LISA ROY MD PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-665-6967
Mailing Address - Street 1:1014 E HIGHWAY 82
Mailing Address - Street 2:SUITE 162
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-2721
Mailing Address - Country:US
Mailing Address - Phone:940-665-6967
Mailing Address - Fax:888-292-0671
Practice Address - Street 1:1014 E HIGHWAY 82
Practice Address - Street 2:SUITE 162
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2721
Practice Address - Country:US
Practice Address - Phone:940-284-3884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty