Healthcare Provider Details

I. General information

NPI: 1982936993
Provider Name (Legal Business Name): OSCAR N LIGHTNER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 11/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9802 MCPHERSON RD SUITE 108
LAREDO TX
78045-6413
US

IV. Provider business mailing address

9802 MCPHERSON RD SUITE 108
LAREDO TX
78045-6413
US

V. Phone/Fax

Practice location:
  • Phone: 830-980-2435
  • Fax: 956-726-6361
Mailing address:
  • Phone: 956-726-0501
  • Fax: 956-726-6361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberG4161
License Number StateTX

VIII. Authorized Official

Name: ADRIANA GARCIA
Title or Position: CONTROLLER
Credential:
Phone: 956-726-0501