Lung Clinic PLLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

P6293 Issued in TX

Legal business name

LUNG CLINIC PLLC

Practice address

555 Creekside Xing
New Braunfels, TX 78130

Phone

(210) 774-5443

Fax

(336) 350-8495

NPI assigned

Nov 20, 2015

Organization subpart

No

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

Authorized official

Name

Abhishek Vedavalli, MDNPI 1942536164

Title

President

Phone

(512) 718-7494

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abhishek Vedavalli, M.B.B.S, MPH, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Indianapolis, IN
  • NPI 1942536164

  TX

  Medicare reassignment NPD Authorized official
• Tasha Timberlake Hinton, DDS

  • General Practice Dentistry
  • Morrisville, NC
  • NPI 1841341633
  NPD
• Veena Reddy, M.D.

  • Family Medicine Physician
  • Austin, TX
  • NPI 1750671137

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1073987533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733537",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733537",
            "telephone_number": "210-774-5443",
            "fax_number": "336-350-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CREEKSIDE XING",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "78130",
            "telephone_number": "210-774-5443",
            "fax_number": "336-350-8495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Union Ave",
            "address_purpose": "LOCATION",
            "city": "New Braunfels",
            "state": "TX",
            "postal_code": "781304194",
            "country_code": "US",
            "telephone_number": "210-774-5443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUNG CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "VEDAVALLI",
        "authorized_official_first_name": "ABHISHEK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-718-7494",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "P6293",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "P6293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3642415-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elissa Ruth Lueckemeyer, RD, LD
• Luke T Lukose, PTA
• Sofia C Luna, P.A.
• Kellie Colleen Lunday, RD, LD
• Christopher Lundgren
• Sarah Elizabeth Lutka, CNP-FNP
• Luxottica of America Inc (Target Optical #E845)
• Timothy Shawler Lybarger, DPT
• Timothy Stuart Lyda, M.D.
• Robert Hornor Lyford, D.D.S.

• Pulmonary Disease Physician in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Pulmonary Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.