OrganizationActive
Liza De Olazo Banaag, M. D., P. A.
NPI 1558497040 · Undersea and Hyperbaric Medicine (Preventive Medicine) Physician · Grenada, MS
Provider details
- NPI number
- 1558497040
- Entity type
- Organization
- Primary specialty
- Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Liza Banaag, Owner(832) 646-5492
- License
- 19748 (MS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
965 J K Avent Dr
Suite 100-A
Grenada, MS 38901-5045
Phone: (662) 227-7446
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 2329
Grenada, MS 38902-2329
Registry dates
- Enumerated
- 2007-02-26
- Last updated
- 2008-01-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.