Healthcare Provider Details

I. General information

NPI: 1003225830
Provider Name (Legal Business Name): HUMA Y. LODHI MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 11/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11351 JAMES WATT DR BLDG F
EL PASO TX
79936-6627
US

IV. Provider business mailing address

11351 JAMES WATT DR BLDG F
EL PASO TX
79936-6627
US

V. Phone/Fax

Practice location:
  • Phone: 915-225-3807
  • Fax: 915-225-3814
Mailing address:
  • Phone: 915-225-3807
  • Fax: 915-225-3814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberK8303
License Number StateTX

VIII. Authorized Official

Name: DR. HUMA Y LODHI
Title or Position: OWNER
Credential: MD
Phone: 915-225-3807