1184859993 NPI number — DR. LEKHA K GEORGE MD

Table of content: DR. LEKHA K GEORGE MD (NPI 1184859993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184859993 NPI number — DR. LEKHA K GEORGE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEORGE
Provider First Name:
LEKHA
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184859993
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3601 4TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79430-0002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-743-3150
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1325 EASTMORELAND,
Provider Second Line Business Practice Location Address:
SUITE 360
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38104-7514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-448-7782
Provider Business Practice Location Address Fax Number:
901-448-5832
Provider Enumeration Date:
05/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  44391 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 4301508289 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: 44391 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: M8667 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 179388 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00007014 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003182121A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1515156 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1184859993 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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