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1750522397
LISA M BASHORE
FORT WORTH, TX
NPI
1750522397
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: TX 673778)
Enumeration Date
2009-03-11
Last Update Date
2021-05-10
Business Address
LISA M BASHORE PNP
1500 COOPER ST
FORT WORTH, TX 76104-2710
Phone number: 682-885-4007
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Mailing Address
LISA M BASHORE PNP
PO BOX 733784
DALLAS, TX 75373-3784
Phone number: 682-885-1855
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