Lisch, Mark S
Lisch, Mark S is an sole proprietor health care provider with primary practice located at 6816 Shadow Creek Ct , Fort Worth TX 76132-4522. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Lisch, Mark S can be contacted via phone (832) 368-6841.Contact Information
Primary practice address
6816 Shadow Creek Ct
Fort Worth TX 76132-4522
Phone: (832) 368-6841
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 0787 | Texas |
Profile Details
NPI number | 1124094958 |
---|---|
LBN Legal business name | Lisch, Mark S |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 23rd, 2006 |
Last updated | Oct 4th, 2021 - about 4 years ago |
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 | 1124094958 | NPPES |
Texas | MEDICAID | 085279001 | |
Texas | Other | 82Y991 | |
Texas | MEDICAID | 092841802 |
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