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NPI Code Detail

MEDICARE: MR. HARRISON LOBDELL IV MD

MEDICARE: MR. HARRISON LOBDELL IV MD
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
1207P00000XEmergency Medicine PhysicianS7268TX
2390200000XStudent in an Organized Health Care Education/Training Program
3207P00000XEmergency Medicine PhysicianC1710KY

General Provider Information

NPI Number : 1154775740
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HARRISON LOBDELL IV MD
Provider Business Mailing Address
First Line : 3620 E WHITESTONE BLVD
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-7441
Country : US
Telephone Number : 512-260-2732
Fax Number :
Provider Business Practice Location Address
First Line : 3620 E WHITESTONE BLVD
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-7441
Country : US
Telephone Number : 512-260-2732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2016
Last Update Date : 04/10/2024

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