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NPI Code Detail

MEDICARE: LYNXCARE PA

MEDICARE: LYNXCARE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianM6480TX
2207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianM6480TX
3208M00000XHospitalist PhysicianM6480TX
4207R00000XInternal Medicine PhysicianM6480TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TXB158820OTHERTXMEDICARE PTAN

General Provider Information

NPI Number : 1124326376
Entity Type Code : Organization
Provider Name (Legal Business Name) : LYNXCARE PA
Provider Business Mailing Address
First Line : 3855 TARTAN LN
Second Line :
City : HOUSTON
State : TX
Zip : 77025-2411
Country : US
Telephone Number : 281-413-8078
Fax Number :
Provider Business Practice Location Address
First Line : 1905 HOLCOMBE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77030-4123
Country : US
Telephone Number : 281-389-9257
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : JOANNA K SMIECHOWSKA-IRA
Credential : MD
Telephone Number : 281-413-8078
Provider Enumeration Date : 03/10/2011
Last Update Date : 05/06/2013

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Directions to “LYNXCARE PA ” Practice Location

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