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DR. LISA DANIELLE BROSTROM MD, FACS
NPI 1124197173
Plastic Surgery in Fort Sam Houston, TX

Active since November 06, 2006PECOS Enrolled
3551 ROGER BROOKE DR BLDG 3600, FORT SAM HOUSTON, TX 78234(210) 269-6113 Get Directions Write a Review

NPPES record last updated: September 12, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Lisa Danielle Brostrom Md, Facs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LISA DANIELLE BROSTROM MD, FACS (NPI 1124197173) is an individual plastic surgery provider in Fort Sam Houston, Texas, licensed in Texas (L4266) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1124197173
Entity TypeIndividualFemale
Primary Taxonomy208200000X
Provider Legal NameDR. LISA DANIELLE BROSTROMCredential: MD, FACS
Location Address3551 ROGER BROOKE DR BLDG 3600Fort Sam Houston, TX 78234-4504
Mailing Address3551 Roger Brooke Dr Bldg 3600Fort Sam Houston, TX 78234-4504 · (210) 269-6113
Phone(210) 269-6113
Sole ProprietorYes
Enumeration DateNovember 6, 2006
Last NPPES UpdateSeptember 12, 2019
✔ NPI 1124197173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in TX · L4266
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
3551 ROGER BROOKE DR BLDG 3600, Fort Sam Houston, TX 78234
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Secondary Practice Location 1

Location 15680 Guilford AveIndianapolis, IN 46220-3267 · Phone (317) 536-5967

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lisa Danielle Brostrom Md, Facs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78234 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH KOSANKE
General Practice
3551 ROGER BROOKE DR BLDG 3600
JBSA FT SAM HOUSTON, TX 78234
Bexar County (210) 916-1925
DR. JOY E WHEAT M.D.
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
3551 ROGER BROOKE DR BLDG 3600
FORT SAM HOUSTON, TX 78234
Bexar County (210) 916-2168
EDWARD RYAN KISSAM AG-ACNP
Nurse Practitioner (Acute Care)
3551 ROGER BROOKE DR BLDG 3600
FORT SAM HOUSTON, TX 78234
Bexar County (210) 916-8003
SHAKIRA CABRERA MPAS
Physician Assistant (Medical)
3551 ROGER BROOKE DR BLDG 3600
SAN ANTONIO, TX 78234
Bexar County (210) 916-4413
MS. SELENA MAGEE VELA PA-C
Physician Assistant
3551 ROGER BROOKE DR BLDG 3600
FORT SAM HOUSTON, TX 78234
Bexar County (210) 916-9023
DR. FAWN S HOGAN M.D.
Plastic Surgery
3551 ROGER BROOKE DR BLDG 3600
FORT SAM HOUSTON, TX 78234
Bexar County (210) 916-3216
NATHAN CHARLES CODDINGTON DDS
Dentist
3551 ROGER BROOKE DR BLDG 3600
JBSA FT SAM HOUSTON, TX 78234
Bexar County (541) 228-2942
DR. BARBARA JEAN HOEBEN PHARMD, MSPHARM
Pharmacist (Pharmacotherapy)
3551 ROGER BROOKE DR BLDG 3600
SAN ANTONIO, TX 78234
Bexar County (210) 916-1518

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Brostrom's NPI number?

The NPI number for Lisa Brostrom is 1124197173. It was assigned to this individual provider in the NPPES registry on November 6, 2006.

Where is Lisa Brostrom located?

Lisa Brostrom practices at 3551 Roger Brooke Dr Bldg 3600, Fort Sam Houston, TX 78234. The listed phone number is (210) 269-6113.

What is Lisa Brostrom's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Lisa Brostrom enrolled in Medicare?

Yes. Lisa Brostrom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lisa Brostrom was last updated on September 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.