1376634469 NPI number — LIDIA LEMARROY

Table of content: JEAN FRANCOIS MAX THOMAS M.D. (NPI 1962424614)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376634469 NPI number — LIDIA LEMARROY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIDIA LEMARROY
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:
6
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:
1376634469
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
309 S TEXAS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESLACO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78596-6113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-969-1323
Provider Business Mailing Address Fax Number:
956-968-8803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1002 CORPUS CHRISTI ST STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAREDO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78040-5265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-728-1323
Provider Business Practice Location Address Fax Number:
956-728-0972
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEMARROY
Authorized Official First Name:
LIDIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
956-969-1323

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 532311 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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