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General NPI Number Information
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NPI Number | 1366865081
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Entity Type | Organization
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Legal Business Name | ROBERT R. LEMKE DDS, MD, PA
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Dates
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Enumeration Date | 01/31/2014
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Last Update Date | 01/31/2014
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Provider Practice Location Address
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Address Line | 14500 SAN PEDRO AVE SUITE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78232-4391
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Country | US
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Telephone | 210-491-0015
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Fax | 210-491-0352
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Provider Business Mailing Address
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Address Line | 14500 SAN PEDRO AVE SUITE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78232-4391
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Country | US
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Telephone | 210-491-0015
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Fax | 210-491-0352
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. ROBERT R. LEMKE
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Credential | DDS, MD, PA
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Telephone | 210-491-0015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 28748
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 15342
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License Number State | TX
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