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General NPI Number Information
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NPI Number | 1003001579
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Entity Type | Organization
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Legal Business Name | KEVIN LANE DO PA
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 4103 WILBARGER ST
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City | VERNON
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State | TX
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Zip | 76384-3137
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Country | US
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Telephone | 940-553-2140
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Fax | 940-553-1739
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Provider Business Mailing Address
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Address Line | 4103 WILBARGER ST
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City | VERNON
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State | TX
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Zip | 76384-3137
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Country | US
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Telephone | 940-553-2140
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Fax | 940-553-1739
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Authorized Official
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Title or Position | DO
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Name | KEVIN B LANE
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Credential |
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Telephone | 940-553-2140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L8579
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License Number State | TX
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