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General NPI Number Information
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NPI Number | 1457903650
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Entity Type | Organization
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Legal Business Name | MCLANE FAMILY PRACTICE, PLLC
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 10 MEDICAL CENTER BLVD STE K2
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City | LUFKIN
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State | TX
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Zip | 75904-3173
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Country | US
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Telephone | 469-744-1820
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MEDICAL CENTER BLVD STE K2
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City | LUFKIN
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State | TX
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Zip | 75904-3173
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Country | US
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Telephone | 936-632-5311
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Fax |
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Authorized Official
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Title or Position | MANAGING PHYSICIAN
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Name | DR. LISA HOLLOWAY MCLANE
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Credential | DO
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Telephone | 936-632-5311
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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 |
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License Number State |
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