Healthcare Provider Details

I. General information

NPI: 1275537847
Provider Name (Legal Business Name): HUMA Y. LODHI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
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

748 DULCE TIERRA DR
EL PASO TX
79912-2617
US

V. Phone/Fax

Practice location:
  • Phone: 915-225-3807
  • Fax: 915-225-3814
Mailing address:
  • Phone: 915-581-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: