Lake Whitney Physicians Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LAKE WHITNEY PHYSICIANS CLINIC LLC

Practice address

202 E Jefferson Ave
Whitney, TX 76692-2398

Phone

(254) 694-2221

Fax

(254) 694-9978

NPI assigned

Aug 15, 2013

Last updated

Aug 15, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Linda Hall

Title

Cfo, Member, Administrator

Phone

(254) 694-2221

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1053744862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E JEFFERSON AVE",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922398",
            "telephone_number": "254-694-2221",
            "fax_number": "254-694-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E JEFFERSON AVE",
            "city": "WHITNEY",
            "state": "TX",
            "postal_code": "766922398",
            "telephone_number": "254-694-2221",
            "fax_number": "254-694-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WHITNEY PHYSICIANS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CFO, MEMBER, ADMINISTRATOR",
        "authorized_official_telephone_number": "254-694-2221"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayesha Siddiqua Khan, D.D.S.
• Bailey E Kudrna, COTA/L
• Lake Whitney Home Health Services
• Lake Whitney Operations, LLC (Paradigm Home Health)
• Lake Whitney Physical Therapy PC
• Lakeside Physicians Management LLC
• Jamie Lee, APRN, FNP-C
• Jorge Armando Marcial, M.D.
• Medical Center
• Rosa Isela Mendoza, RN

• Family Medicine Physician in Whitney, TX
• Providers in Whitney, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.