Provider Demographics
NPI:1063991719
Name:MALONE, LISA DAWN (RN)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:DAWN
Last Name:MALONE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 LBJ FWY STE 900
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-6151
Mailing Address - Country:US
Mailing Address - Phone:214-370-3385
Mailing Address - Fax:
Practice Address - Street 1:5001 LBJ FWY STE 900
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-6151
Practice Address - Country:US
Practice Address - Phone:214-370-3385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX594464163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse