Basic Information
| Provider Information | |||||||||
| NPI: | 1821118126 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REMEDIOS | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | GABRIELLE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9817 BLUFF DALE DR | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752182143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143215654 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5 WASHINGTON PL | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031106736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036952500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 10/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | M1315 | TX | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 22934 | NH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.