Phanthavong, Souksavanh Lisa

Phanthavong, Souksavanh Lisa is an individual health care provider with primary practice located at 4001 Long Prairie Rd Ste 125 , Flower Mound TX 75028-1532. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Phanthavong, Souksavanh Lisa can be contacted via phone (972) 539-3030.

Contact Information

Primary practice address
4001 Long Prairie Rd Ste 125 Flower Mound TX 75028-1532
Phone: (972) 539-3030
Fax: (972) 539-3037
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA07876 Texas

Profile Details

NPI number 1619222874
LBN Legal business name Phanthavong, Souksavanh Lisa
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2012
Last updated Jan 11th, 2017 - about 7 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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