Provider Demographics
NPI:1336386499
Name:WOODCOCK, LISA JAYNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:JAYNE
Last Name:WOODCOCK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:JAYNE
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 LONG PRAIRIE RD
Mailing Address - Street 2:SUITE 146
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4217
Mailing Address - Country:US
Mailing Address - Phone:972-874-2584
Mailing Address - Fax:972-874-2587
Practice Address - Street 1:1900 LONG PRAIRIE RD
Practice Address - Street 2:SUITE 146
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4217
Practice Address - Country:US
Practice Address - Phone:972-874-2584
Practice Address - Fax:972-874-2587
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1069516225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist