MEDICARE: LCI PREFERRED HEALTHCARE MANAGEMENT, LLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1225419690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LCI PREFERRED HEALTHCARE MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	1530 GOODYEAR DR
Second Line	:	SUITE A
City	:	EL PASO
State	:	TX
Zip	:	79936-6062
Country	:	US
Telephone Number	:	915-256-0544
Fax Number	:

Provider Business Practice Location Address
First Line	:	1530 GOODYEAR DR
Second Line	:	SUITE A
City	:	EL PASO
State	:	TX
Zip	:	79936-6062
Country	:	US
Telephone Number	:	915-256-0544
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LIRIA ACUNA
Credential	:
Telephone Number	:	915-256-0544

Provider Enumeration Date	:	06/11/2015
Last Update Date	:	06/11/2015

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