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NPI Code Detail

MEDICARE: LMO HEALTHCARELLC

MEDICARE: LMO HEALTHCARELLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1336373513
Entity Type Code : Organization
Provider Name (Legal Business Name) : LMO HEALTHCARELLC
Provider Business Mailing Address
First Line : 4161 E HIGHWAY 290
Second Line : STE 400
City : DRIPPING SPRINGS
State : TX
Zip : 78620-4446
Country : US
Telephone Number : 512-858-9580
Fax Number : 512-858-9582
Provider Business Practice Location Address
First Line : 4161 E HIGHWAY 290
Second Line : STE 400
City : DRIPPING SPRINGS
State : TX
Zip : 78620-4446
Country : US
Telephone Number : 512-858-9580
Fax Number : 512-858-9582
Authorized Official
Title or Position : PRESIDENT/MEMBER
Name : JORGE ORTIZ
Credential : MD
Telephone Number : 512-858-9590
Provider Enumeration Date : 05/04/2009
Last Update Date : 05/04/2009

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Directions to “LMO HEALTHCARELLC ” Practice Location

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