1306892203 NPI number — DR. SHAUN D LEHMANN M.D.

Table of content: DR. SHAUN D LEHMANN M.D. (NPI 1306892203)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306892203 NPI number — DR. SHAUN D LEHMANN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEHMANN
Provider First Name:
SHAUN
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1306892203
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1567
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOMBALL
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77377-1567
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-357-5454
Provider Business Mailing Address Fax Number:
281-357-5499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25216 GROGANS PARK DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
THE WOODLANDS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77380-2175
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-357-5454
Provider Business Practice Location Address Fax Number:
281-357-5499
Provider Enumeration Date:
05/25/2006

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: 2081S0010X , with the licence number:  K7182 , 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: 8H4600 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 146753202 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 460517474 . This is a "TAX IDENTIFICATION NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com