| Doctor Name: | LISA MARIE RANDALL |
| NPI Number: | 1114229945 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, ACNS-BC |
| License Number: | 710385 |
| Business Practice Address: | 351 Cypress Creek Rd Suite 100 Cedar Park, TX - 786134528 |
| Business Phone Number: | 5124263627 |
| Business Fax Number: | 5123287488 |
| Mailing Address: | 351 Cypress Creek Rd, Suite 100 CEDAR PARK |
| State: | TX |
| Postal Code: | 786134528 |
| Phone Number: | 5124263627 |
| Fax Number: | 5123287488 |
| NPI Enumeration Date: | 11/30/2010 |
| NPI Last Update Date: | 11/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SA2200X |
| License Number: | 710385 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |