Banaag, Liza De Olazo
Banaag, Liza De Olazo is an sole proprietor health care provider with primary practice located at 17218 Preston Rd # 2000 , Dallas TX 75252-4018. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Banaag, Liza De Olazo can be contacted via phone (877) 866-7123.Contact Information
Primary practice address
17218 Preston Rd # 2000
Dallas TX 75252-4018
Phone: (877) 866-7123
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine | 2083P0011X | K5793 | Texas |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | K5793 | Texas |
Profile Details
NPI number | 1194916874 |
---|---|
LBN Legal business name | Banaag, Liza De Olazo |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 7th, 2007 |
Last updated | Jun 19th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1194916874 | NPPES |
Texas | MEDICAID | 096334004 |
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