Healthcare Provider Details

I. General information

NPI: 1487682100
Provider Name (Legal Business Name): LOLA C. MORGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 03/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 FLOYD CURL DR FL 8
SAN ANTONIO TX
78229-3931
US

IV. Provider business mailing address

8300 FLOYD CURL DR FL 8
SAN ANTONIO TX
78229-3931
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-9700
  • Fax: 210-450-6039
Mailing address:
  • Phone: 210-450-9700
  • Fax: 210-450-6039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberM7446
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberM7446
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: