Provider Demographics
NPI:1346248093
Name:L & W ORTHOPAEDIC ASSOCIATES
Entity Type:Organization
Organization Name:L & W ORTHOPAEDIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:LITKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-498-4791
Mailing Address - Street 1:PO BOX 830398
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75083-0398
Mailing Address - Country:US
Mailing Address - Phone:972-498-4791
Mailing Address - Fax:972-498-4939
Practice Address - Street 1:403 W CAMPBELL RD
Practice Address - Street 2:SUITE 320
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3465
Practice Address - Country:US
Practice Address - Phone:972-498-4791
Practice Address - Fax:972-498-4939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1529968001Medicaid
TX6316980001Medicare NSC
TX00839NMedicare ID - Type Unspecified