MEDICARE: LIDIA LEMARROY

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	532312	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1154412260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIDIA LEMARROY

Provider Business Mailing Address
First Line	:	309 S TEXAS BLVD
Second Line	:
City	:	WESLACO
State	:	TX
Zip	:	78596-6113
Country	:	US
Telephone Number	:	956-969-1323
Fax Number	:	956-968-8803

Provider Business Practice Location Address
First Line	:	2605 BOCA CHICA BLVD
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78521-2311
Country	:	US
Telephone Number	:	956-542-0333
Fax Number	:	956-986-2175

Authorized Official
Title or Position	:	OWNER
Name	:	LIDIA LEMARROY
Credential	:	CERTIFIED PEDORTHIST
Telephone Number	:	956-969-1323

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	11/03/2010

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