Souksavanh Lisa Phanthavong, PA-C
NPI #1619222874 in Flower Mound, Texas
Provider Information
- NPI Number
- 1619222874
- Entity Type
- Individual
- Name
- Souksavanh Lisa Phanthavong, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jul 13, 2012
- Last Updated
- Aug 12, 2025
Practice Location
- Address
- 4001 LONG PRAIRIE RD STE 125
- City
- Flower Mound
- State
- Texas
- ZIP Code
- 75028-1532
- Phone
- (972) 539-3030
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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