Medwedeff, Lisa Elaine

Medwedeff, Lisa Elaine is an sole proprietor health care provider with primary practice located at 5425 W Spring Creek Parkway Suite 210 , Plano TX 75024. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Medwedeff, Lisa Elaine can be contacted via phone (972) 608-3333.

Contact Information

Primary practice address
5425 W Spring Creek Parkway Suite 210 Plano TX 75024
Phone: (972) 608-3333
Fax: (972) 473-7333
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X K1257 Texas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X K1257 Texas

Profile Details

NPI number 1104827799
LBN Legal business name Medwedeff, Lisa Elaine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2005
Last updated Nov 9th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104827799 NPPES
Texas MEDICAID 0299083-01

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