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NPI Code Detail

MEDICARE: DR. ELENA LAVROVSKAYA M.D.

MEDICARE: DR. ELENA LAVROVSKAYA M.D.
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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianM8779TX
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMD2021-0025NM

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00902944OTHERTXMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699973016
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELENA LAVROVSKAYA M.D.
Provider Business Mailing Address
First Line : PO BOX 681149
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78268-1149
Country : US
Telephone Number : 210-558-6288
Fax Number : 210-558-6289
Provider Business Practice Location Address
First Line : 3300 NACOGDOCHES RD
Second Line : SUITE 110
City : SAN ANTONIO
State : TX
Zip : 78217-3373
Country : US
Telephone Number : 210-646-0890
Fax Number : 210-646-7764
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2007
Last Update Date : 05/31/2024

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