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Liza De Olazo Banaag, M.D., P.A.

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Company Details

Name: Liza De Olazo Banaag, M.D., P.A.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Dissolved
Effective Date: 19 Aug 2008 (17 years ago)
Business ID: 936961
ZIP code: 38902
County: Grenada
State of Incorporation: TEXAS
Principal Office Address: 965 Avent Drive Suite 100 (38901);P O Box 2329Grenada, MS 38902

Agent

Name Role Address
Banaag, Liza O Agent 965 Avent Drive Suite 100 (38901);P O Box 2329, Grenada, MS 38902

President

Name Role Address
Liza De Olazo Banaag President PO Box 2329, Grenada, MS 38902

Director

Name Role Address
Liza De Olazo Banaag Director P. O. Box 2329, Grenada, MS 38902

National Provider Identifier

NPI Number:
1558497040

Authorized Person:

Name:
DR. LIZA DE OLAZO BANAAG
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2083P0011X - Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2012-12-07 Admin Dissolution
Notice to Dissolve/Revoke Filed 2012-09-13 Notice to Dissolve/Revoke
Annual Report Filed 2011-04-19 Annual Report
Annual Report Filed 2010-04-12 Annual Report
Annual Report Filed 2009-04-15 Annual Report
Formation Form Filed 2008-08-19 Formation

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Date of last update: 08 May 2025

Sources: Company Profile on Mississippi Secretary of State Website