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1124094958
MARK S LISCH
FORT WORTH, TX
NPI
1124094958
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
213E00000X Podiatrist
(Licence: TX 0787)
Enumeration Date
2006-02-23
Last Update Date
2021-10-04
Business Address
MARK S LISCH dpm
6816 SHADOW CREEK CT
FORT WORTH, TX 76132-4522
Phone number: 832-368-6841
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Mailing Address
MARK S LISCH dpm
PO BOX 16918
FORT WORTH, TX 76162-0918
Phone number: 323-686-8418
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