Provider Demographics
NPI:1275537847
Name:LODHI, HUMA Y (MD)
Entity Type:Individual
Prefix:
First Name:HUMA
Middle Name:Y
Last Name:LODHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 DULCE TIERRA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2617
Mailing Address - Country:US
Mailing Address - Phone:915-581-0239
Mailing Address - Fax:
Practice Address - Street 1:11351 JAMES WATT DR
Practice Address - Street 2:BLDG F
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6627
Practice Address - Country:US
Practice Address - Phone:915-225-3807
Practice Address - Fax:915-225-3814
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8303208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0401515-01Medicaid
TXG97528Medicare UPIN
TX0401515-01Medicaid