MEDICARE: LOTUS COMMUNITY BIRTHING CENTER PLLC

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	261QB0400X	Birthing Clinic/Center

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

General Provider Information

NPI Number	:	1811502255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS COMMUNITY BIRTHING CENTER PLLC

Provider Business Mailing Address
First Line	:	11403 HORNSBY ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78753-2627
Country	:	US
Telephone Number	:	512-736-4591
Fax Number	:	512-957-2702

Provider Business Practice Location Address
First Line	:	13805 ANN PL APT B
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78728-7742
Country	:	US
Telephone Number	:	512-736-4591
Fax Number	:	512-957-2702

Authorized Official
Title or Position	:	OWNER,
Name	:	VARSHNA NARUMANCHI
Credential	:	LM
Telephone Number	:	512-736-4591

Provider Enumeration Date	:	09/12/2020
Last Update Date	:	09/12/2020

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