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General NPI Number Information
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NPI Number | 1629005590
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Entity Type | Individual
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Provider Name | LANNA B MCCLAIN MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 225 SE JOHN JONES DR
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City | BURLESON
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State | TX
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Zip | 76028-8341
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Country | US
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Telephone | 817-447-0445
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Fax | 817-447-2273
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Provider Business Mailing Address
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Address Line | PO BOX 733784
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City | DALLAS
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State | TX
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Zip | 75373-3784
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Country | US
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Telephone | 682-885-1855
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Fax | 682-885-1396
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J6574
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License Number State | TX
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