Provider Demographics
NPI:1912328832
Name:MHLOYI, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MHLOYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18950 LINA ST
Mailing Address - Street 2:APT 1223
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-2447
Mailing Address - Country:US
Mailing Address - Phone:469-579-8825
Mailing Address - Fax:
Practice Address - Street 1:18950 LINA ST
Practice Address - Street 2:APT 1223
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-2447
Practice Address - Country:US
Practice Address - Phone:469-579-8825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver