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General NPI Number Information
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NPI Number | 1891069589
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Entity Type | Organization
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Legal Business Name | LRMC PHYSICIAN SERVICES, INC.
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 100 MEDICAL PARKWAY
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City | LAKEWAY
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State | TX
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Zip | 78734
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Country | US
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Telephone | 512-263-9102
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MEDICAL PARKWAY
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City | LAKEWAY
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State | TX
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Zip | 78734
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Country | US
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Telephone | 512-263-9102
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. DAVID KREYE
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Credential |
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Telephone | 512-263-9102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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