Provider Demographics
NPI:1336100791
Name:LUMMUS, JIMMIE D (DPM)
Entity Type:Individual
Prefix:DR
First Name:JIMMIE
Middle Name:D
Last Name:LUMMUS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:BALLINGER
Mailing Address - State:TX
Mailing Address - Zip Code:76821-0617
Mailing Address - Country:US
Mailing Address - Phone:325-365-2531
Mailing Address - Fax:
Practice Address - Street 1:2001 HUTCHINS AVE STE C
Practice Address - Street 2:
Practice Address - City:BALLINGER
Practice Address - State:TX
Practice Address - Zip Code:76821-4453
Practice Address - Country:US
Practice Address - Phone:325-365-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0847213E00000X, 213ES0131X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018722102Medicaid
TX8F1500OtherBCBS
TXA002OtherTRICARE
TXA002OtherTRICARE
TXT14512Medicare UPIN