1366535452 NPI number — ANDREW G LASHUS MD

Table of content: ANDREW G LASHUS MD (NPI 1366535452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366535452 NPI number — ANDREW G LASHUS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LASHUS
Provider First Name:
ANDREW
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1366535452
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7557 RAMBLER RD STE 290
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75231-0101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-331-9700
Provider Business Mailing Address Fax Number:
972-331-9833

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7557 RAMBLER RD STE 290
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-0101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-331-9700
Provider Business Practice Location Address Fax Number:
972-331-9833
Provider Enumeration Date:
10/02/2006

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: 2080P0202X , with the licence number:  K8279 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0202X , with the licence number: 29076 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1366535452 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 105678001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6049274 . This is a "CIGNA PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 124228 . This is a "SUPERIOR PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 140442852 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1095872 . This is a "FIRSTHEALTH PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 87Z128 . This is a "BCBSTX IND PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00U87Z . This is a "BCBSTX GRP PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 105678005 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1750369203 . This is a "GRP NPI NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10027967 . This is a "AMERIGROUP PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 117425100 . This is a "FIRSTCARE PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 137345810 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1469416 . This is a "UHC PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 7186010 . This is a "AETNA PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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