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General NPI Number Information
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NPI Number | 1578569893
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Entity Type | Organization
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Legal Business Name | CONSULTANTS IN INFECTIOUS DISEASES
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 4404 C 19TH
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City | LUBBOCK
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State | TX
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Zip | 79407
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Country | US
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Telephone | 806-795-8150
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Fax | 806-791-6688
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Provider Business Mailing Address
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Address Line | PO BOX 16327
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City | LUBBOCK
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State | TX
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Zip | 79490-6327
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Country | US
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Telephone | 806-795-8150
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Fax | 806-791-6688
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. LAWRENCE P MARTINELLI
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Credential | M.D.
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Telephone | 806-795-8150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | J3849
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License Number State | TX
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