Provider Demographics
NPI:1306851134
Name:LC RESPIRATORY EQUIPMENT
Entity Type:Organization
Organization Name:LC RESPIRATORY EQUIPMENT
Other - Org Name:LONNIE HEBERT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-480-8900
Mailing Address - Street 1:PO BOX 1425
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77549
Mailing Address - Country:US
Mailing Address - Phone:281-480-8900
Mailing Address - Fax:281-218-7969
Practice Address - Street 1:17000 EL CAMINO REAL STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2633
Practice Address - Country:US
Practice Address - Phone:281-480-8900
Practice Address - Fax:281-218-7969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0081091332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1768517Medicaid
TX1768517Medicaid