1992086524 NPI number — LAMAR J ALBRITTON MD PA

Table of content: (NPI 1992086524)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992086524 NPI number — LAMAR J ALBRITTON MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAMAR J ALBRITTON MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1992086524
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7922 EWING HALSELL DR
Provider Second Line Business Mailing Address:
430
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78229-3786
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-614-3275
Provider Business Mailing Address Fax Number:
210-692-9654

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7922 EWING HALSELL DR
Provider Second Line Business Practice Location Address:
430
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-3786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-614-3275
Provider Business Practice Location Address Fax Number:
210-692-9654
Provider Enumeration Date:
09/09/2011

Additional Information

Authorized Official

Authorized Official Last Name:
ALBRITTON
Authorized Official First Name:
LAMAR
Authorized Official Middle Name:
J
Authorized Official Title or Position:
MD, PRESIDENT
Authorized Official Telephone Number:
210-614-3275

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 287133701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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