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General NPI Number Information
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NPI Number | 1386884286
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Entity Type | Individual
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Provider Name | LOVELY PHILIPOSE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1950 EPHRIHAM AVE
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City | FORT WORTH
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State | TX
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Zip | 76164-6670
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Country | US
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Telephone | 817-813-7075
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746079
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City | ATLANTA
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State | GA
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Zip | 30374-6079
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Country | US
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Telephone | 773-352-1515
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Fax | 312-929-0373
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | S0536
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.094372
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License Number State | OH
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