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General NPI Number Information
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NPI Number | 1720277437
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Entity Type | Organization
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Legal Business Name | WEST TEXAS LUNG CLINIC PA
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 06/10/2015
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Provider Practice Location Address
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Address Line | 1904 PINE ST STE. 4C
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City | ABILENE
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State | TX
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Zip | 79601-2449
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Country | US
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Telephone | 325-670-4033
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Fax | 325-670-4051
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Provider Business Mailing Address
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Address Line | 1904 PINE ST STE. 4C
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City | ABILENE
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State | TX
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Zip | 79601-2449
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Country | US
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Telephone | 325-670-4033
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Fax | 325-670-4051
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAMARA STOJANOVIC
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Credential | MD
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Telephone | 325-670-4033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | K7622
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License Number State | TX
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